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ALL / Cardiology
Pregnancy: DVT/PE investigation
Pregnancy: DVT/PE investigation
Guidelines were updated in 2015 by the Royal College of Obstetricians.For patients with a suspected deep vein thrombosis (DVT):
- Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT
For patients with a suspected pulmonary embolism (PE):
- ECG and chest x-ray should be performed in all patients
- In women who also have symptoms and signs of DVT, compression duplex ultrasound should be performed. If compression ultrasonography confirms the presence of DVT, no further investigation is necessary and treatment for VTE should continue
- the decision to perform a V/Q or CTPA should be taken at a local level after discussion with the patient and radiologist
Comparing CTPA to V/Q scanning in pregnancy
| CTPA | V/Q scanning |
|---|---|
| CTPA slightly increases the lifetime risk of maternal breast cancer (increased by up to 13.6%, background risk of 1/200 for study population). Pregnancy makes breast tissue particularly sensitive to the effects of radiation | V/Q scanning carries a slightly increased risk of childhood cancer compared with CTPA (1/50,000 versus less than 1/1,000,000) |
D-dimer is of limited use in the investigation of thromboembolism as it often raised in pregnancy.
+PassMedicine Notes
Guidelines were updated in 2015 by the Royal College of Obstetricians.
For patients with a suspected deep vein thrombosis (DVT):- Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT
- ECG and chest x-ray should be performed in all patients
- In women who also have symptoms and signs of DVT, compression duplex ultrasound should be performed. If compression ultrasonography confirms the presence of DVT, no further investigation is necessary and treatment for VTE should continue
- the decision to perform a V/Q or CTPA should be taken at a local level after discussion with the patient and radiologist
Comparing CTPA to V/Q scanning in pregnancy
CTPA _ V/Q scanning| CTPA slightly increases the lifetime risk of maternal breast cancer (increased by up to 13.6%, background risk of 1/200 for study population). Pregnancy makes breast tissue particularly sensitive to the effects of radiation _ V/Q scanning carries a slightly increased risk of childhood cancer compared with CTPA (1/50,000 versus less than 1/1,000,000)|D-dimer is of limited use in the investigation of thromboembolism as it often raised in pregnancy.