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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Pulmonary embolism in pregnancy. Consensus and controversies
1Department of Obstetrics and Gynecology, Northwestern University, Deefield, IL, USA. benson@northwestern.edu
Minerva Ginecologica
|September 29, 2012
Summary
Venous thrombotic events (VTE) are a leading cause of maternal death. Diagnosis in pregnancy requires advanced imaging, and treatment involves anticoagulation, but prophylaxis remains uncertain.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Cardiology
Background:
- Venous thrombotic events (VTE) are a significant cause of maternal mortality globally.
- Key risk factors include personal VTE history and inherited thrombophilias.
- Diagnostic challenges exist due to limitations of D-dimer testing in pregnancy.
Purpose of the Study:
- To outline current diagnostic and treatment strategies for VTE in pregnant patients.
- To address the uncertainties surrounding VTE prophylaxis in high-risk pregnancies.
Main Methods:
- Compression ultrasound for deep venous thrombosis, followed by MRI if suspicion remains.
- Chest X-ray triage for pulmonary embolism, leading to V/Q scan or CTPA.
- Treatment with low molecular weight heparin, with consideration for thrombolysis in severe cases.
Main Results:
- Diagnostic algorithms prioritize imaging over D-dimer tests.
- Low molecular weight heparin is the standard treatment, extending postpartum.
- Evidence for mechanical prophylaxis, especially post-cesarean, is limited.
Conclusions:
- Accurate VTE diagnosis in pregnancy relies on specific imaging protocols.
- Anticoagulation is crucial for treatment, but prophylactic strategies require further research.
- The efficacy of mechanical prophylaxis in cesarean patients is not well-established.
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