title: The diagnostic role of ventilation/perfusion scans versus computed tomography pulmonary angiography in obstetric patients investigated for pulmonary embolism at Wellington Hospital from 2010 to 2012.
abstract: OBJECTIVE
  To develop best practice clinical guidelines for the use of ventilation/perfusion (V/Q) scanning and computed tomography perfusion angiography (CTPA) in pregnancy and the postpartum period.
  
  
  METHODS
  Retrospective analysis of the clinical findings and radiologic investigation for pulmonary embolism (PE) in obstetric women at Wellington Hospital from 2010 to 2012.
  
  
  RESULTS
  Fifty-four women were investigated for PE with a V/Q scan or CTPA, including 29 antenatal women and 25 postnatal women. Eleven (37.9%) antenatal women had V/Q scans and 18 (62%) had CTPAs. Five (20%) postnatal women had V/Q scans, 19 (76%) had CTPAs and one (4%) had a V/Q scan followed by a CTPA. Three of the 54 women (5.6%) had a positive radiologic finding of PE (two by V/Q scan and one by CTPA). Four (22.2%) antenatal women and 5 (25%) postnatal women had a diagnosis made on CTPA, which was not seen on chest x-ray.
  
  
  CONCLUSIONS
  This audit found that clinicians varied in their investigation of cases suspected of PE. We have proposed a clinical pathway for the investigation of PE in pregnancy and the postpartum period.
authors.forename: Sally
authors.initials: S
authors.lastname: Easther
authors.affiliation: Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021. fali.langdana@otago.ac.nz.
authors.forename: Fali
authors.initials: F
authors.lastname: Langdana
authors.forename: Richard
authors.initials: R
authors.lastname: Beasley
authors.forename: Dushyant
authors.initials: D
authors.lastname: Maharaj
authors.forename: James
authors.initials: J
authors.lastname: Entwisle
authors.forename: Peter
authors.initials: P
authors.lastname: Abels
mesh_terms: D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014692:Ventilation-Perfusion Ratio