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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Choi, Hyun Krishnamoorthy, Dinesh |
| Abstract | Background Pulmonary embolism (PE) during pregnancy remains one of the leading causes of maternal morbidity and mortality in the developed world. However, there is a paucity of high-quality evidence resulting in a lack of consensus in managing this group of patients. The aims of the study were to address the diagnostic utility of D-dimer for suspected PE in pregnant and post-partum patients and to identify any clinical presentation variables that are predictors of PE in this group of patients. Methods A retrospective case note review of 152 pregnant and post-partum patients who underwent diagnostic imaging (ventilation/perfusion (V/Q) or computed tomographic pulmonary angiography (CTPA)) for suspected PE at a tertiary teaching hospital from 2007 to 2011 was conducted. The reference range for D-dimer was less than 0.5 mg/L as being normal. The following variables were also assessed in terms of their predictive capability for PE diagnosis in pregnancy: heart rate (HR), mean arterial pressure (MAP), shock index (SI) and A-a gradient. Results The application of D-dimer testing for suspected PE in this study population had a sensitivity of 100% (95% CI, 73–100%), specificity of 42% (95% CI, 31–53%) and a likelihood negative ratio of 0. None of the clinical variables were significant predictors of PE according to regression analyses. Conclusions There is supportive evidence that a negative D-dimer result is useful as a means of ruling out PE in pregnant and post-partum patients. However, we need a larger prospective observational study to collaborate the findings. |
| Related Links | https://intjem.biomedcentral.com/counter/pdf/10.1186/s12245-018-0169-8.pdf |
| Ending Page | 6 |
| Page Count | 6 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 18651380 |
| DOI | 10.1186/s12245-018-0169-8 |
| Journal | International Journal of Emergency Medicine |
| Issue Number | 1 |
| Volume Number | 11 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2018-03-05 |
| Access Restriction | Open |
| Subject Keyword | Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Pulmonary embolism Pregnancy Post-partum D-dimer |
| Content Type | Text |
| Resource Type | Article |
| Subject | Emergency Medicine |
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