Pregnancy and Acute Pulmonary Embolism

Women who are pregnant or in the postpartum period and women who take hormonal therapy are at an increased risk of pulmonary embolism.

Some facts:

• Risk of first episode of venous thromboembolism is 15 times as high in the postpartum period as during pregnancy
• Diagnostic workup and initial ED therapy is the same as it is for non-pregnant patients
• Although there are still some concerns about pulmonary CTA, both the American College of Obstetrics & Gynecology and the American College of Radiology agree that it is safe. It is unknown what happens to fetal nephrons after exposure to circulating contrast in the mother. Despite this, CTA can be used without fear if indicated. 
• Warfarin is a teratogen and should not be used for anticoagulation.

 

References

 Tapson V. Acute Pulmonary Embolism. N Engl J Med 2008;358:1037-52