title: [Pulmonary embolism and pregnancy].
abstract: OBJECTIVE
  Pulmonary embolism remains a leading cause of maternal death in France and in other developed countries. Prevention is well codified, but management remains complex both for diagnosis and therapeutics. The objective of this review was to update the knowledge on diagnosis and treatment of pulmonary embolism during pregnancy.
  Review.
  
  
  METHODS
  Medline(®) database looking for articles published in English or French between 1965 and 2012, using pulmonary embolism, pregnancy, heparin, thrombolysis and vena cava filter as keywords. Editorials, original articles, reviews and cases reports were selected.
  
  
  RESULTS
  Pulmonary embolism is one of the leading causes of maternal death in France. Clinical signs and biologic tests are not specific during pregnancy. Doppler ultrasound is helpful for diagnosis and avoids maternal and fetal radiation. Treatment is based on full anticoagulation. Low molecular weight heparin is the treatment of choice. A temporary vena cava filter may be proposed, especially at the end of pregnancy, or when heparin is contraindicated. In case of pulmonary embolism with cardiogenic shock, thrombolysis is an alternative treatment.
  
  
  CONCLUSIONS
  Diagnostic approach is first based on the use of ultrasound- Doppler, and frequently on-to computed tomographic pulmonary angiography or ventilation-perfusion lung scanning. The treatment is based on low molecular weight heparin. Others therapeutics, such as thrombolysis or temporary vena cava filter, may be useful in certain circumstances.
authors.affiliation: EA MATN 4564 IFR 150, département d'anesthésie et de réanimation, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 9, France.
authors.forename: L
authors.initials: L
authors.lastname: Lonjaret
authors.forename: O
authors.initials: O
authors.lastname: Lairez
authors.forename: V
authors.initials: V
authors.lastname: Minville
authors.forename: F
authors.initials: F
authors.lastname: Bayoumeu
authors.forename: O
authors.initials: O
authors.lastname: Fourcade
authors.forename: F-J
authors.initials: FJ
authors.lastname: Mercier
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012770:Shock, Cardiogenic / Q000150:complications / Q000188:drug therapy; D018608:Ultrasonography, Doppler; D016306:Vena Cava Filters
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight