{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:08:05Z","timestamp":1790359685183,"version":"4.1.0"},"reference-count":23,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The low prevalence of pulmonary embolism (PE) among pregnant patients presenting with suspected PE implies that most of these patients will be found not have the disease. Given this low prevalence, excluding PE in this population has necessitated the use of sensitive and specific diagnostic imaging, such as computed tomography pulmonary angiography or ventilation-perfusion scanning. Recent studies suggest that a clinical prediction rule with D-dimer testing can also be used to exclude a subset of pregnant patients with suspected PE without the need for diagnostic imaging. The YEARS criteria, which consist of clinical signs and symptoms of deep venous thrombosis, hemoptysis, and PE as the most likely diagnosis (a subjective variable), combined with selective D-dimer levels, seem to safely exclude up to one-third of these patients without imaging. The revised Geneva rule using objective variables, combined with nonpregnancy cutoffs for D-dimer levels, offers some promise, although fewer patients avoided imaging (14%). These recent studies provide evidence in support of radiation avoidance for some patients; however, for most, imaging remains the only option. Future studies should focus on improving the safety and techniques of imaging modalities, in addition to improving the specificity of D-dimer testing and objective prediction rules. Studies assessing patients\u2019 and physicians\u2019 values, preferences, and risk perceptions are also required to assist clinicians in shared decision making when counseling pregnant patients with suspected PE.<\/jats:p>","DOI":"10.1182\/hematology.2020000105","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T03:04:28Z","timestamp":1607137468000},"page":"184-189","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":11,"title":["Can pregnancy-adapted algorithms avoid diagnostic imaging for pulmonary embolism?"],"prefix":"10.1182","volume":"2020","author":[{"given":"Wee-Shian","family":"Chan","sequence":"first","affiliation":[{"name":"BC Women\u2019s Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"4","key":"2020121621162867500_B1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"key":"2020121621162867500_B2","unstructured":"Royal College of Obstetricians & Gynaecologists. Thromboembolic disease in pregnancy and the puerperium: acute management\u2014green-top guideline No. 37b, April 2015. https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/gtg-37b.pdf."},{"key":"2020121621162867500_B3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.thromres.2017.06.025","article-title":"Guidance for the diagnosis of pulmonary embolism during pregnancy: consensus and controversies","volume":"157","author":"Wan","year":"2017","journal-title":"Thromb Res"},{"issue":"1","key":"2020121621162867500_B4","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3324\/haematol.2018.196121","article-title":"Computed tomography pulmonary angiography versus ventilation-perfusion lung scanning for diagnosing pulmonary embolism during pregnancy: a systematic review and meta-analysis","volume":"104","author":"Tromeur","year":"2019","journal-title":"Haematologica"},{"issue":"1","key":"2020121621162867500_B5","first-page":"CD011053","article-title":"Imaging for the exclusion of pulmonary embolism in pregnancy.","volume":"1","author":"van Mens","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"2020121621162867500_B6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.7326\/0003-4819-132-3-200002010-00009","article-title":"Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review","volume":"132","author":"Rathbun","year":"2000","journal-title":"Ann Intern Med"},{"issue":"20","key":"2020121621162867500_B7","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.1001\/jama.1990.03440200057023","article-title":"Value of the ventilation\/perfusion scan in acute pulmonary embolism. 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