Diagnosis and management of pulmonary embolism among pregnant patients

A. Petca, A.M. Plopan, R. Petca, N. Măru, I. Pacu, M. Zvâncă

Rezumat: Pulmonary embolism is one of the emergency situations that require a lot of preparation and a good clinical sense to avoid those scenarios in which this pathology is overdiagnosed, with an increased consumption of financial resources and an unjustified exposure of the patient to radiation, or omitted, with the occurrence of complications or even death. In order to facilitate the diagnosis algorithm of the pulmonary embolism, several management guidelines have been proposed, without being able to establish with certainty which is the suitable moment when the laboratory analyses or the imaging investigations should be used for the correct diagnosis of the embolism. As pulmonary embolism is one of the leading causes of mortality among pregnant women in developed countries, with a mortality of approximately 15-30%, the correct and rapid diagnosis of this pathology is a priority. Although there are several laboratory investigations that can guide the clinician to the diagnosis of pulmonary embolism, many of them must be interpreted in the context of the modified biological profile encountered during pregnancy. Also, the frequent need to use imaging investigations should be carefully evaluated to reduce the risks of radiation exposure of the foetus and breast tissue, or the administration of the contrast agent. However, the correct diagnosis and treatment of pulmonary embolism should not be delayed.
Cuvinte cheie: pulmonary embolism, fetal-maternal irradiation, prophylaxis, correct diagnosis.