VPB1422 - Revision of the diagnostic methods used for the detection of pulmonary embolism in pregnant women at the Centre Hospitalier Universitaire de Sherbrooke

Background: The diagnosis of pulmonary embolism in pregnant women poses a particular challenge, given that several symptoms of pulmonary embolism are often expected findings in pregnant women, and that patients and some clinicians may be reluctant to use imaging for fear of radiation.

Aims: We aim to describe the incidence of pulmonary embolism in pregnant patients in which this diagnosis was suspected in our hospital and to compare it with the 5% incidence found in medical literature. We also want to describe the use of serum D-dimer assay in our hospital and assess whether there has been an increase in its use since the appearance of the ARTEMIS study in march 2019.

Methods: We collected data from our local computerized clinical record for all pregnant patients aged 18 to 45 who underwent an investigation for pulmonary embolism between January 2015 and November 2019.

Results: Of the 186 of these patients, 4 (2.2%; 95% CI [0.84% - 5.40%]) were diagnosed with a confirmed pulmonary embolism. There was no statistically significant difference with the value of 5% found in the literature (p value at 0.07). Before March 2019, serum D-dimer was measured in 57.7% of pregnant patients in whom there was suspicion of pulmonary embolism. After March 2019, D-dimer was measured in 82.6% of these patients, representing a statistically significant increase in their use before and after March 2019, with a p-value of 0.02.

Conclusion(s): These results demonstrate that there is no statistically significant difference between the incidence of pulmonary embolism in pregnant women in which this diagnosis is suspected in our hospital and that found in medical literature. Secondary, we have found an increase in the use of D-dimer in the diagnostic approach for pulmonary embolism in pregnant patients in our hospital after March 2019.