[Incidence and diagnosis of pulmonary embolism during pregnancy - A comparative study between two Swedish regions]

Pulmonary embolism during pregnancy is a potentially life-threatening condition and the second leading cause of maternal mortality in Sweden. Diagnosis during pregnancy is challenging, and radiologic diagnostic modality is important. The incidence of pulmonary embolism among pregnant women in the Swedish region of Dalarna was 47.8/100 000 women aged 15-49 years in 2016, compared with 5.4/100 000 women in the region of Värmland, which is a region comparable in size and population. This study aimed to investigate differences in clinical practice and choice of imaging modality among pregnant women with suspected pulmonary embolism in the two regions during 2013-2017. There was no difference in background maternal characteristics, but the primary modality of diagnostic imaging was lung scintigraphy in Dalarna (79 percent), whereas computed tomography pulmonary angiography was performed in 75 percent of the cases in Värmland (P < 0.01). There were more women with a confirmed diagnosis of pulmonary embolism after diagnostic imaging in Dalarna (25 percent, n = 65) compared to Värmland (5 percent, n = 8) (P < 0,.01). Pulmonary embolism was diagnosed in more than one quarter of women investigated with scintigraphy, compared to 6 percent when computed tomography was performed.