Podcast #320: PE in Pregnancy

Podcast #320: PE in Pregnancy

Author: Don Stader, M.D.

Educational Pearls:

  • Pulmonary embolism is one of the leading causes of maternal mortality.
  • There is disagreement among different medical societies about the value of D-dimer as a screening modality. If you use it, consider the rational D-dimer approach whereby you add 250 to your cut-off for every trimester.
  • A useful screening modality is an ultrasound of bilateral lower extremities looking for DVT.
  • Keep in mind, both a V/Q scan and CT scan have a significant amount of radiation. CTA is probably the right diagnostic test (less radiation than CT w&w/o).
  • Always use the shared decision-making model and clinical acumen to choose your tests.

References:

Leung AN, et. al. (2011). An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy. American Journal of Respiratory and Critical Care Medicine. 184(10):1200-8

Polak JF, Wilkinson DL. (1991). Ultrasonographic diagnosis of symptomatic deep venous thrombosis in pregnancy. American Journal of Obstetrics and Gynecology. 165(3):625-9.

Sachs BP, et. al. (1987). Maternal mortality in Massachusetts. Trends and prevention. New England Journal of Medicine. 316(11):667-72.

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Podcast #497: Does my patient with CP have ACS?

Podcast #497: Does my patient with CP have ACS?

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Podcast # 496: Hallucinogens

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Podcast # 495: Trauma in the Elderly

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Podcast #494: A Standard Toxicology Approach

Podcast #494: A Standard Toxicology Approach

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Podcast # 493: One Pill for the Kill

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Contributor: JP Brewer, MD Educational Pearls: Because of their smaller size, there are a variety of adult-dose pills that are potentially toxic to children. The most common categories of medication...

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Podcast # 492: Pain While on Buprenorphine

Podcast # 492: Pain While on Buprenorphine

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Podcast # 491: Buprenorphine for Withdrawal

Podcast # 491: Buprenorphine for Withdrawal

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Podcast # 490: Canadian Syncope Rule

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