Pulmonary Embolism in Pregnancy

Unfortunately the the normal pathway for investigation of PE performs poorly in pregnancy RCOG have the following pathway

1. Investigation – of suspected PE

  • Clinical assessment – its all on the history and exam scoring doesn’t work
  • Perform the following tests:
    • CXR – sheilding can protect the baby and may avoid further radiation
    • ECG
    • Bloods: FBC, U&E, LFTs
  • Commence Dalteparin (unless treatment is contraindicated) – BNF
  • Arrange admission to AAU/AMU (>20/40  AMU @CRH and inform Obstetrics)

2. Signs/Symps of DVT?

  • Yes – Order Ultrasound doppler for ? DVT (As if this is positive theres no need to look for a PE)
  • No – Medical team will need to review to consider VQ vs CTPA

RCOG Guidance

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