The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy.
AffiliationDepartment of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.
Predictive Value of Tests
Pregnancy Complications, Cardiovascular
MetadataShow full item record
CitationThe application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy. 2011, 24 (12):1461-4 J. Matern. Fetal. Neonatal. Med.
JournalThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
AbstractTo examine the use of the modified Wells score in pregnancy as a risk stratification tool in the diagnosis of pulmonary embolism (PE).
All pregnant or post-partum patients who were referred for CT Pulmonary Angiography (CTPA) to evaluate suspected PE over a 5-year period were included in the study. Patient records were used to apply the modified Wells score (MWS) and analyze their risk of PE.
A total of 125 women were referred for CTPA over 5 years. A MWS of 6 or greater ("High Risk") was 100% sensitive and 90% specific with a positive predictive value of 36% for PE on CTPA. No patients with a low MWS (less than 6) had a PE, giving a negative predictive value of 100%. p≤0.001. D-dimers, chest X-ray, blood gases and EKG were significantly less effective than the MWS in aiding the diagnosis of PE.
Current methods employed for the diagnosis of PE are inadequate. Risk stratification using the MWS may allow safe exclusion of PE before resorting to CTPA. To the best of our knowledge this is the first study to have used the MWS in a pregnant patient group.
- Evaluation of the utility of the Wells score in predicting pulmonary embolism in patients admitted to a spine surgery service.
- Authors: Wang JH, Christino MA, Thakur NA, Palumbo MA, Daniels AH
- Issue date: 2013 Feb
- Clinical probability score and D-dimer estimation lack utility in the diagnosis of childhood pulmonary embolism.
- Authors: Biss TT, Brandão LR, Kahr WH, Chan AK, Williams S
- Issue date: 2009 Oct
- [Suspicion of pulmonary embolism: added value of CT depends on patient characteristics and referring individual].
- Authors: de Bruin S, van Langevelde K, Huisman MV, Cannegieter SC
- Issue date: 2012
- The value of ischemia-modified albumin compared with d-dimer in the diagnosis of pulmonary embolism.
- Authors: Turedi S, Gunduz A, Mentese A, Topbas M, Karahan SC, Yeniocak S, Turan I, Eroglu O, Ucar U, Karaca Y, Turkmen S, Russell RM
- Issue date: 2008 May 30
- Different accuracies of rapid enzyme-linked immunosorbent, turbidimetric, and agglutination D-dimer assays for thrombosis exclusion: impact on diagnostic work-ups of outpatients with suspected deep vein thrombosis and pulmonary embolism.
- Authors: Michiels JJ, Gadisseur A, van der Planken M, Schroyens W, De Maeseneer M, Hermsen JT, Trienekens PH, Hoogsteden H, Pattynama PM
- Issue date: 2006 Oct