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Objective <p>Interest in pulmonary embolism (PE) has undergone a renaissance since the emergence of COVID-19 pandemic, but PE researches among pregnant mothers in this post-COVID-19 era remains scarce. This study was conducted to (a) determine PE prevalence rate among pregnant and post-partum women with suspected PE after the COVID 19 pandemic, (b) compare the clinical characteristics, laboratory findings and CT features between the PE and non-PE cohorts, and (c) validate the Pregnancy-Adapted Geneva (PAG) score in our population.</p> Methods <p>This retrospective cross-sectional study involved the review of all maternal cases with suspected PE who underwent diagnostic CTPA in year 2022.</p> Results <p>A total of 120 patients represented by 90 pregnant patients and 30 post-partum patients were included in the analysis. The prevalence rate of PE was 22.5% (27/120) and gestational diabetes mellitus prevalence rate was significantly higher (48.1% vs. 26.9%; p = 0.037) in PE cohort. Besides, the proportion of patients with moderately and extremely raised peak D-dimer levels were significantly higher among the PE cohort. In patients with PE, the position of the most proximal clot was identified as subsegmental (n = 6, 22.2%) and segmental (n = 21; 77.8%). The predicted PE risk based on PAG score demonstrated poor calibration with the observed PE risk across all three groups, namely low-risk group (2.3% vs. 15.4%), intermediate-risk group (11.6% vs. 26.3%) and high-risk groups (61.5% vs. 0.0%).</p> Conclusion <p>Overall, PE among pregnant and post-partum populations remain a convoluted disease without distinctive clinical features. There is a need for a prospectively validated PE risk scores to guide its clinical diagnostic pathway.</p>

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Prevalence and Clinical Features of Pulmonary Embolism in Pregnancy and Puerperium in the Post-COVID-19 Era

  • 期刊论文

  • 发表日期：

    2025年3月14日

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  • Thai Lun Tan,
  • Noor Emillia Binti Illa,
  • Siew Ying Ting,
  • Shoen Chuen Chiew,
  • De Yee Gan,
  • Zhong Wei Ong,
  • Vijayan

摘要

Objective

Interest in pulmonary embolism (PE) has undergone a renaissance since the emergence of COVID-19 pandemic, but PE researches among pregnant mothers in this post-COVID-19 era remains scarce. This study was conducted to (a) determine PE prevalence rate among pregnant and post-partum women with suspected PE after the COVID 19 pandemic, (b) compare the clinical characteristics, laboratory findings and CT features between the PE and non-PE cohorts, and (c) validate the Pregnancy-Adapted Geneva (PAG) score in our population.

Methods

This retrospective cross-sectional study involved the review of all maternal cases with suspected PE who underwent diagnostic CTPA in year 2022.

Results

A total of 120 patients represented by 90 pregnant patients and 30 post-partum patients were included in the analysis. The prevalence rate of PE was 22.5% (27/120) and gestational diabetes mellitus prevalence rate was significantly higher (48.1% vs. 26.9%; p = 0.037) in PE cohort. Besides, the proportion of patients with moderately and extremely raised peak D-dimer levels were significantly higher among the PE cohort. In patients with PE, the position of the most proximal clot was identified as subsegmental (n = 6, 22.2%) and segmental (n = 21; 77.8%). The predicted PE risk based on PAG score demonstrated poor calibration with the observed PE risk across all three groups, namely low-risk group (2.3% vs. 15.4%), intermediate-risk group (11.6% vs. 26.3%) and high-risk groups (61.5% vs. 0.0%).

Conclusion

Overall, PE among pregnant and post-partum populations remain a convoluted disease without distinctive clinical features. There is a need for a prospectively validated PE risk scores to guide its clinical diagnostic pathway.