Clinical predictors of pulmonary embolism in pregnancy and immediate postpartum period: a retrospective, analytical study
Date
2022-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University, 2022
Abstract
ENGLISH ABSTRACT: Background
Although pulmonary embolism (PE) is one of the leading causes of death in pregnancy and
postpartum, it has low risk of adverse outcome if diagnosed early and treated appropriately.
Ventilation-perfusion scanning (VQ scan) or computed tomography pulmonary angiogram (CTPA)
are widely used to confirm or diagnose PE, however it carries risks to the mother and the fetus.
Up to date, there is no validated clinical predicting tool that can be used in pregnancy and
postpartum, thus clinicians face a challenge when suspecting PE in pregnancy and postpartum.
Furthermore, the lack of medical resources in low resource environments contributes to the
delay of investigations and diagnosis of PE. This study aimed to describe clinical markers for suspicious PE amongst pregnant mothers and immediate postpartum and to design a practical, clinical tool for accurate diagnosis of PE peripartum in our population.
Methods
The study was performed as a retrospective and analytical study over a period of four months, in
the Obstetric Unit at Tygerberg Academic Hospital.
The files (total 100) of the patients who were suspected of having PE and underwent imaging (VQ
scan or CTPA) were retrospectively evaluated (ECM) to see if there was an association between
clinical presentation and PE. All obstetric patients who were imaged for suspected PE, antenatal
and immediate postpartum admitted to F2, C2A, OCCU, J2, J4 and J5 were included but not any
patients already known with PE or varicose thrombosis.
Results
There was a statistically significant (P <0.05) association between PE occurrence and ten assessed
factors (surgery in <4/52, immobilization >3/7, SOB, hemoptysis, sudden onset of pleuritic chest
pain, respiratory alkalosis, sinus tachycardia, deep S1, Q3/T3 and HIV).
Conclusion
The researcher designed a clinical PE predicting tool that may be used in pregnancy and
postpartum.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (PhD) -- Stellenbosch University, 2022.
Keywords
Pulmonary embolism, Pregnancy -- Complications, Puerperium, Ventilation-perfusion ratio