Journal of thrombosis and haemostasis : JTH · 2026
Diagnostic management of suspected acute pulmonary embolism in the postpartum period.
СтатьяМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bhangu Gurjeet, Greutert Sophie, Robert-Ebadi Helia, Kline Jeffrey, Righini Marc, Penaloza Andrea, Perrier Arnaud, Ghanima Waleed, Mallick Ranjeeta, Takada Toshihiko, van Es Nick, Klok Frederikus A, Geersing Geert-Jan, Le Gal Grégoire, Skeith Leslie
Аннотация
BACKGROUND: Pregnancy and the postpartum period increase the risk of venous thromboembolism including pulmonary embolism (PE), which is an important cause of maternal morbidity and mortality. While diagnostic strategies for suspected PE in pregnancy have evolved, postpartum patients remain underrepresented in research.
OBJECTIVES: This study evaluated diagnostic strategies and the incidence of PE among postpartum patients presenting to an acute care setting with suspected PE, using data from a previously published individual patient data meta-analysis.
METHODS: We analyzed 201 postpartum patients from 6 studies included in the individual patient data meta-analysis. Primary outcomes were PE incidence and a description of the diagnostic tests used. Secondary outcomes included the performance of retrospectively calculated clinical decision rules (CDRs) including the revised Geneva score, pregnancy-adapted Geneva (PAG) score, and pulmonary embolism rule-out criteria (PERC), in combination with D-dimer testing and imaging.
RESULTS: Among 201 postpartum patients with suspected PE, the incidence was 6.0% (95% CI, 2.9%-12.3%). The revised Geneva and PERC CDRs performed similarly to previously published data. Notably, 29% (29/100, 95% CI, 21%-39%) of postpartum patients had a negative D-dimer result, and none of those with a negative result were diagnosed with PE, regardless of the CDR used.
CONCLUSION: The observed PE incidence of 6.0% in this postpartum cohort underscores the need for evidence-based diagnostic pathways for physicians. Given that 29% of patients had a negative D-dimer and none were diagnosed with PE, diagnostic algorithms incorporating D-dimer testing could be applied in postpartum evaluations.
OBJECTIVES: This study evaluated diagnostic strategies and the incidence of PE among postpartum patients presenting to an acute care setting with suspected PE, using data from a previously published individual patient data meta-analysis.
METHODS: We analyzed 201 postpartum patients from 6 studies included in the individual patient data meta-analysis. Primary outcomes were PE incidence and a description of the diagnostic tests used. Secondary outcomes included the performance of retrospectively calculated clinical decision rules (CDRs) including the revised Geneva score, pregnancy-adapted Geneva (PAG) score, and pulmonary embolism rule-out criteria (PERC), in combination with D-dimer testing and imaging.
RESULTS: Among 201 postpartum patients with suspected PE, the incidence was 6.0% (95% CI, 2.9%-12.3%). The revised Geneva and PERC CDRs performed similarly to previously published data. Notably, 29% (29/100, 95% CI, 21%-39%) of postpartum patients had a negative D-dimer result, and none of those with a negative result were diagnosed with PE, regardless of the CDR used.
CONCLUSION: The observed PE incidence of 6.0% in this postpartum cohort underscores the need for evidence-based diagnostic pathways for physicians. Given that 29% of patients had a negative D-dimer and none were diagnosed with PE, diagnostic algorithms incorporating D-dimer testing could be applied in postpartum evaluations.