Diagnosis of venous thromboembolic disease during pregnancy
Robert-Ebadi, H.; Righini, M.
Revue Medicale Suisse 7(281): 345-350
2011
ISSN/ISBN: 1660-9379 PMID: 21416713 Document Number: 652095
Venous thromboembolism (VTE) remains the leading cause of maternal mortality in western countries. The similarity between some of the physiological symptoms of pregnancy and symptoms of VTE makes the diagnosis difficult. The D-dimers can be useful for the exclusion of VTE during the first two trimesters of pregnancy. In case of suspicion of DVT, the diagnosis can be made by non-invasive means with lower limb venous compression ultrasonography (CUS). In case of suspicion of PE, pulmonary imaging is often necessary. Scintigraphy is the best validated diagnostic test, but helical computed tomography is frequently proposed due to its higher availability. Fetal radiation is very low with both imaging techniques, and the potentially fatal outcome of undiagnosed PE widely justifies performing these tests.