4 doctors weighed in:

What test(s) do doctors run to rule out pulmonary embolism in a pregnant woman? 20 gs wks, no leg pain, shortness of breath, cough and chest pain for 4 days after long distance traveling.

4 doctors weighed in
Dr. Daniel Saurborn
Diagnostic Radiology
1 doctor agrees

In brief: Xray -> VQ -> CT

Without leg symptoms, one would not perform a leg ultrasound (DVT US).
With SOB, a chest Xray is first choice, and can be performed safely by shielding the baby. If Xray is normal, then a nuclear medicine VQ scan is performed. If the VQ scan is indeterminate, a CT Pulmonary Angiogram is performed, with settings designed to reduce radiation dose to mother and fetus.

In brief: Xray -> VQ -> CT

Without leg symptoms, one would not perform a leg ultrasound (DVT US).
With SOB, a chest Xray is first choice, and can be performed safely by shielding the baby. If Xray is normal, then a nuclear medicine VQ scan is performed. If the VQ scan is indeterminate, a CT Pulmonary Angiogram is performed, with settings designed to reduce radiation dose to mother and fetus.
Dr. Daniel Saurborn
Dr. Daniel Saurborn
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2 comments
Dr. Daniel Saurborn
http://www.thoracic.org/statements/resources/pvd/evaluation-of-suspected-pulmonary-embolism-in-pregnancy.pdf
Dr. Daniel Saurborn
In a follow up to your question, you said that you have had a history of cancer, and you would like to avoid additional radiation exposure. I completely understand! The problem with D-dimer in pregnancy is that it is less specific. In other words, if the result is negative, then you don't have PE. But if it's positive, you might or might not have PE and you'd still need imaging.
Dr. John Ricotta
Surgery - Vascular

In brief: Tough one

most of the test for PE involve either IV dye or radiation or both Venous ultrasound can look for clots in the legs - if negative that is a good sign.
Clot in the pelvis is hard to identify without radiation. IF there is a real clinical concern you could have a CTAngiogram of the chest with your abdomen shielded but you would have to discuss with your doctor to see the level of his/her concern

In brief: Tough one

most of the test for PE involve either IV dye or radiation or both Venous ultrasound can look for clots in the legs - if negative that is a good sign.
Clot in the pelvis is hard to identify without radiation. IF there is a real clinical concern you could have a CTAngiogram of the chest with your abdomen shielded but you would have to discuss with your doctor to see the level of his/her concern
Dr. John Ricotta
Dr. John Ricotta
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Dr. Edgar Mendizabal
Internal Medicine

In brief: Arterial

blood gasses. If normal, you are ok

In brief: Arterial

blood gasses. If normal, you are ok
Dr. Edgar Mendizabal
Dr. Edgar Mendizabal
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