Prevalence and Clinical Features of Pulmonary Embolism in Pregnancy and Puerperium in the Post-COVID-19 Era.

IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Maternal and Child Health Journal Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI:10.1007/s10995-025-04067-w
Thai Lun Tan, Noor Emillia Binti Illa, Siew Ying Ting, Shoen Chuen Chiew, De Yee Gan, Zhong Wei Ong, Vijayan
{"title":"Prevalence and Clinical Features of Pulmonary Embolism in Pregnancy and Puerperium in the Post-COVID-19 Era.","authors":"Thai Lun Tan, Noor Emillia Binti Illa, Siew Ying Ting, Shoen Chuen Chiew, De Yee Gan, Zhong Wei Ong, Vijayan","doi":"10.1007/s10995-025-04067-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Interest in pulmonary embolism (PE) has undergone a renaissance since the emergence of COVID-19 pandemic, but PE researches among pregnant mothers in this post-COVID-19 era remains scarce. This study was conducted to (a) determine PE prevalence rate among pregnant and post-partum women with suspected PE after the COVID 19 pandemic, (b) compare the clinical characteristics, laboratory findings and CT features between the PE and non-PE cohorts, and (c) validate the Pregnancy-Adapted Geneva (PAG) score in our population.</p><p><strong>Methods: </strong>This retrospective cross-sectional study involved the review of all maternal cases with suspected PE who underwent diagnostic CTPA in year 2022.</p><p><strong>Results: </strong>A total of 120 patients represented by 90 pregnant patients and 30 post-partum patients were included in the analysis. The prevalence rate of PE was 22.5% (27/120) and gestational diabetes mellitus prevalence rate was significantly higher (48.1% vs. 26.9%; p = 0.037) in PE cohort. Besides, the proportion of patients with moderately and extremely raised peak D-dimer levels were significantly higher among the PE cohort. In patients with PE, the position of the most proximal clot was identified as subsegmental (n = 6, 22.2%) and segmental (n = 21; 77.8%). The predicted PE risk based on PAG score demonstrated poor calibration with the observed PE risk across all three groups, namely low-risk group (2.3% vs. 15.4%), intermediate-risk group (11.6% vs. 26.3%) and high-risk groups (61.5% vs. 0.0%).</p><p><strong>Conclusion: </strong>Overall, PE among pregnant and post-partum populations remain a convoluted disease without distinctive clinical features. There is a need for a prospectively validated PE risk scores to guide its clinical diagnostic pathway.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"428-437"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maternal and Child Health Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10995-025-04067-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Interest in pulmonary embolism (PE) has undergone a renaissance since the emergence of COVID-19 pandemic, but PE researches among pregnant mothers in this post-COVID-19 era remains scarce. This study was conducted to (a) determine PE prevalence rate among pregnant and post-partum women with suspected PE after the COVID 19 pandemic, (b) compare the clinical characteristics, laboratory findings and CT features between the PE and non-PE cohorts, and (c) validate the Pregnancy-Adapted Geneva (PAG) score in our population.

Methods: This retrospective cross-sectional study involved the review of all maternal cases with suspected PE who underwent diagnostic CTPA in year 2022.

Results: A total of 120 patients represented by 90 pregnant patients and 30 post-partum patients were included in the analysis. The prevalence rate of PE was 22.5% (27/120) and gestational diabetes mellitus prevalence rate was significantly higher (48.1% vs. 26.9%; p = 0.037) in PE cohort. Besides, the proportion of patients with moderately and extremely raised peak D-dimer levels were significantly higher among the PE cohort. In patients with PE, the position of the most proximal clot was identified as subsegmental (n = 6, 22.2%) and segmental (n = 21; 77.8%). The predicted PE risk based on PAG score demonstrated poor calibration with the observed PE risk across all three groups, namely low-risk group (2.3% vs. 15.4%), intermediate-risk group (11.6% vs. 26.3%) and high-risk groups (61.5% vs. 0.0%).

Conclusion: Overall, PE among pregnant and post-partum populations remain a convoluted disease without distinctive clinical features. There is a need for a prospectively validated PE risk scores to guide its clinical diagnostic pathway.

后新冠肺炎时代妊娠和产褥期肺栓塞的患病率及临床特征
目的:自新冠肺炎大流行以来,人们对肺栓塞(PE)的兴趣重新燃起,但后新冠肺炎时代孕妇PE的研究仍然很少。本研究旨在(a)确定COVID - 19大流行后疑似PE的孕妇和产后妇女的PE患病率,(b)比较PE和非PE队列的临床特征、实验室结果和CT特征,以及(c)验证我们人群中的妊娠适应日内瓦(PAG)评分。方法:本回顾性横断面研究回顾了2022年所有接受CTPA诊断的疑似PE的产妇病例。结果:共纳入120例患者,其中孕妇90例,产后30例。PE患病率为22.5%(27/120),妊娠期糖尿病患病率显著高于前者(48.1% vs. 26.9%;p = 0.037)。此外,中度和极度升高d -二聚体峰值水平的患者比例在PE队列中明显更高。在PE患者中,最近端血栓的位置被确定为亚节段性(n = 6, 22.2%)和节段性(n = 21;77.8%)。根据PAG评分预测的PE风险与观察到的PE风险在所有三组,即低风险组(2.3% vs. 15.4%)、中风险组(11.6% vs. 26.3%)和高风险组(61.5% vs. 0.0%)中校准较差。结论:总的来说,PE在孕妇和产后人群中仍然是一种复杂的疾病,没有明显的临床特征。需要前瞻性验证的PE风险评分来指导其临床诊断途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Maternal and Child Health Journal
Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.20
自引率
4.30%
发文量
271
期刊介绍: Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信