Diagnosis of suspected venous thromboembolic disease in pregnancy.
Venous thromboembolic disease is a leading cause of maternal mortality during pregnancy. Early and accurate radiological diagnosis is essential as anticoagulation is not without risk and clinical diagnosis is unreliable. Although the disorder is potentially treatable, unnecessary treatment should be avoided. Most of the diagnostic imaging techniques involve ionizing radiation which exposes both the mother and fetus to finite radiation risks. There is a relative lack of evidence in the literature to guide clinicians and radiologists on the most appropriate method of assessing this group of patients. This article will review the role of imaging of suspected venous thromboembolic disease in pregnant patients, highlight contentious issues such as radiation risk, intravenous contrast use in pregnancy and discuss the published guidelines, as well as suggesting an appropriate imaging algorithm based on the available evidence.
Scarsbrook
A F
AF
Department of Radiology, Churchill Hospital, Oxford Radcliffe NHS Trust, Headington, Oxford, UK.
Evans
A L
AL
Owen
A R
AR
Gleeson
F V
FV
D000465:Algorithms; D000792:Angiography / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply; D018810:Magnetic Resonance Angiography / Q000379:methods; D010690:Phlebography / Q000379:methods; D010992:Plethysmography, Impedance / Q000379:methods; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging / Q000009:adverse effects; D013923:Thromboembolism / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography
D003287:Contrast Media