Thai Lun Tan, Noor Emillia Binti Illa, Siew Ying Ting, Shoen Chuen Chiew, De Yee Gan, Zhong Wei Ong, Vijayan
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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.
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。
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.