{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:51:03Z","timestamp":1790128263347,"version":"4.0.1"},"reference-count":56,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2014,9]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>Pregnancy causes a small increase in risk of venous thromboembolism (VTE<\/jats:styled-content>), but a large increase in concern upon presentation to an emergency department (ED<\/jats:styled-content>) with symptoms of pulmonary embolism (PE<\/jats:styled-content>), which may cause physicians to employ a low test threshold. This was a systematic review with the hypothesis that symptomatic pregnant patients in the ED<\/jats:styled-content> have a low relative risk (RR<\/jats:styled-content>) for VTE<\/jats:styled-content> outcome.<\/jats:p><\/jats:sec>Methods<\/jats:title>Studies in all languages were identified by structured search of PubMed, EMBASE<\/jats:styled-content>, the Cochrane library, and bibliographies in February 2014. Papers with ED<\/jats:styled-content> patients evaluated for possible PE<\/jats:styled-content> that included pregnancy status, and had adequate reference standards, were included. An outcome of VTE<\/jats:styled-content> (either deep venous thrombosis [DVT<\/jats:styled-content>] or PE<\/jats:styled-content>) was considered disease\u2010positive (VTE<\/jats:styled-content>+). Papers were assessed for selection and publication bias, and heterogeneity (I2<\/jats:sup>). The random effects model was used if I2<\/jats:sup>\u00a0>\u00a024%.<\/jats:p><\/jats:sec>Results<\/jats:title>Seventeen full\u2010length studies of 25,339 patients were analyzed. Pooled data showed I\u00b2\u00a0=\u00a00% with a symmetrical funnel plot. Two small studies with less than 1% of all patients had evidence of selection bias. The frequency of VTE<\/jats:styled-content>+ rate among the 506 pregnant patients was 4.1% (95% confidence interval [CI<\/jats:styled-content>]\u00a0=\u00a02.6% to 6.0%), compared with 12.4% (95% CI<\/jats:styled-content>\u00a0=\u00a09.0% to 16.3%) among nonpregnant patients. The pooled RR<\/jats:styled-content> of pregnancy for VTE<\/jats:styled-content>+ diagnosis was 0.60 (95% CI<\/jats:styled-content>\u00a0=\u00a00.41 to 0.87). Patients in the third trimester had a RR<\/jats:styled-content> of 0.85 (95% CI<\/jats:styled-content>\u00a0=\u00a00.40 to 1.77), and patients of childbearing age (\u226445\u00a0years) had a RR<\/jats:styled-content> of 0.56 (95% CI<\/jats:styled-content>\u00a0=\u00a00.34 to 0.93).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In the ED<\/jats:styled-content> setting, physicians test for PE<\/jats:styled-content> in pregnant patients at a low threshold, resulting in a low rate of VTE<\/jats:styled-content> diagnosis and a RR<\/jats:styled-content> of VTE<\/jats:styled-content> that is lower than that for nonpregnant women of childbearing age who are tested for PE<\/jats:styled-content> in the ED<\/jats:styled-content> setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12471","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T07:59:12Z","timestamp":1412150352000},"page":"949-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Systematic Review and Meta\u2010analysis of Pregnant Patients Investigated for Suspected Pulmonary Embolism in the Emergency Department"],"prefix":"10.1111","volume":"21","author":[{"given":"Jeffrey A.","family":"Kline","sequence":"first","affiliation":[{"name":"The Department of Emergency Medicine Indianapolis IN"},{"name":"The Department of Cellular and Integrative Physiology Indianapolis IN"},{"name":"Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine Indianapolis 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