Evaluation of CTPA interpreted as limited in pregnant patients suspected for pulmonary embolism

AbstractPurposeThe purpose of this study is to determine the rates of CT pulmonary angiography (CTPA) interpreted as limited and severely limited in pregnant patients suspected for pulmonary embolism (PE), and to evaluate factors that influence these rates.MethodsThis is a retrospective study with CTPA for evaluation of PE in pregnancy across a large health system from 2006 to 2017. CTPA was classified as limited from the radiology report with a subset of those studies classified as severely limited. Bivariate and multivariate analysis was performed for limited and severely limited rates with maternal age and patient size as a continuous variable and race, trimester, patient location study priority status, and result of chest radiograph before CTPA as categorical variables.Results874 patients with 33% of studies limited and 4% of studies severely limited. Multivariate logistic regression of CTPA studies revealed decreasing patient age (OR 0.967,p = 0.0129) and increasing patient size (OR 1.013,p 
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research

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CONCLUSIONS: The current report described two rare cases of ischemic stroke caused by CAD secondary to APS, along with a review of the literature; the patients displayed characteristic clinical manifestations, implying specific mechanisms for cerebral artery disorders secondary to APS. PMID: 33016197 [PubMed - as supplied by publisher]
Source: Lupus - Category: Rheumatology Authors: Tags: Lupus Source Type: research
This article reviews the ECMO experience in this population at a large urban hospital. Electronic medical records for all pregnant or postpartum patients who required ECMO between 2012 and 2019 were retrospectively reviewed. Data on clinical characteristics, outcomes, and complications were gathered. Comparisons between survivors and nonsurvivors were completed. Ten postpartum patients were identified. The patients presented as follows: four with cardiac arrest, one with a massive pulmonary embolism, three with acute respiratory distress syndrome (ARDS), one with combined ARDS and cardiogenic shock, and one with suspected ...
Source: Journal of Extra-Corporeal Technology - Category: Cardiovascular & Thoracic Surgery Tags: J Extra Corpor Technol Source Type: research
CONCLUSION: Placenta accreta spectrum without previa is less likely to be diagnosed antepartum, potentially missing the opportunity for multidisciplinary team management. Despite the absence of placenta previa and less placental invasion, severe maternal morbidity at delivery was not lower. Broader recognition of patients at risk for placenta accreta spectrum may improve early clinical diagnosis and patient outcomes. PMID: 32769646 [PubMed - as supplied by publisher]
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Authors: Malhamé I, Tagalakis V, Dayan N Abstract Pulmonary embolism (PE) complicates 5.4 per 10 000 pregnancies and remains a significant cause of maternal mortality. Prompt diagnosis and treatment of PE are key to ensuring optimal outcomes, but are not without risks associated with over-testing. Given the paucity of evidence informing PE diagnosis in pregnancy, marked heterogeneity exists among different societies in their recommendations. Here we provide an overview of existing recommendations and novel evidence informing the diagnosis of PE in pregnancy, including the use of d-dimers, the choice of diagn...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Authors: Al Oweidat K, Al Ryalat SA, Al Husban N, Alhawari H, Ghareeb R, Ribie M, Jwaied S, Al Yasjeen S, Juweid ME Abstract OBJECTIVE: To determine whether a pregnancy-adapted clinical and D-dimer-based algorithm, termed the "YEARS algorithm," can reduce the need for radiological imaging, including lung scintigraphy in pregnant women with suspected pulmonary embolism (PE). PATIENTS AND METHODS: This retrospective study included all pregnant women with suspected PE between January 2014 and September 2019 who have undergone D-dimer testing and radiological imaging (computed tomography pulmonary angiogr...
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
erg I Abstract Although venous thromboembolism (VTE) is a leading cause of maternal mortality, there is a paucity of real-world clinical data on clinical presentation and management of VTE during pregnancy and postpartum period. Using data from the international RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry, pregnant and postpartum women with VTE were identified. Baseline characteristics, risk factors, therapies, and outcomes were compared. From March 2001 to July 2019, 596 pregnant and 523 postpartum women had symptomatic, objectively confirmed VTE. Pregnant or postpartum women were le...
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
AbstractThose who are infected withSevere Acute Respiratory Syndrome ‐related CoronaVirus‐2 are theoretically at increased risk of venous thromboembolism during self ‐isolation, if they have reduced mobility or are dehydrated. Should patients develop coronavirus disease (COVID‐19) pneumonia requiring hospital admission for treatment of hypoxia, the risk for thromboembolic complications increases greatly. These thromboembolic events are the result of at least two distinct mechanisms – microvascular thrombosis in the pulmonary system (immunothrombosis) and hospital‐associated venous thromboembolism. Since pre...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: STATE ‐OF‐THE‐ART REVIEW Source Type: research
Authors: Çakır Ç, Ceylan Y, Karagöz A, Ökten MŞ, Kaya Y Abstract Objectives: Performing percutaneous mitral commissurotomy (PMC) in the women with asymptomatic severe mitral stenosis (MS) who plan a pregnancy is recommended. However the data regarding this recommendation is limited in the literature. We aimed to investigate maternal and fetal outcomes of women with asymptomatic severe MS who underwent PMC before a planned pregnancy.Methods: We retrospectively analysed the procedural, pregnancy related, and fetal outcomes of 33 consecutive women with severe asymptomatic MS, age 27.97&thinsp...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
Publication date: Available online 21 June 2020Source: Journal of Cardiology CasesAuthor(s): Miyu Ohno, Toshihiro Yamada, Yasuhiro Otsuka, Naoya Nakashima, Junichi Matsubara, Masakazu Matsukawa, Daisuke Sueta, Yuichiro Arima, Eiichiro Yamamoto, Shinji Tamaya, Koichi Kaikita, Kazuteru Fujimoto, Kenichi Tsujita
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
ConclusionsPulmonary embolism ‐related fatality remains substantial in pregnant women with pulmonary embolism and represents a frequent cause of maternal mortality. The use of systemic thrombolysis was reported in one third of pregnant women with pulmonary embolism and haemodynamic failure. Better preventive and management str ategies should be urgently implemented in this vulnerable patient group.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
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