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Pulmonary embolism (PE) is more common in pregnancy. However, pregnant patients have been excluded from most trials of PE risk-stratification algorithms, and serum d-dimer levels normally increase with duration of pregnancy. Thus, evidence regarding the optimal evaluation of pregnant patients with suspected PE has been lacking.
Researchers developed a protocol that involved pretest probability determination (using the revised Geneva score), high-sensitivity d-dimer measurement (cutoff, 500 µg/L), bilateral lower extremity ultrasound, and computed tomography (CT) pulmonary angiography. They tested the protocol prospectively in pregnant women with clinically suspected PE who presented to 11 hospitals in France and Switzerland over an 8-year pe…