Imaging Pregnant Patients with Suspected Pulmonary Embolism: What the Radiologist Needs to Know

Jay K. Pahade, MD , Diana Litmanovich, MD , Ivan Pedrosa, MD Janneth Romero, MD , Alexander A. Bankier, MD , Phillip M. Boiselle, MD

Pregnancy is associated with a fivefold increase in the prevalence of venous thromboembolism, and pulmonary embolism is a leading cause of maternal death. However, the diagnosis of pulmonary em­bolism during pregnancy is challenging because classic clinical symp­toms are often absent and physiologic changes during pregnancy can mimic pulmonary embolism. Concerns about exposure of the fetus to ionising radiation and intravenously administered contrast material, as weir as potential medicolegal issues, further complicate the diagnosis. Although diagnostic imaging plays an important role in this setting, there are currently no widely accepted guidelines for radiologists and clinicians to follow. Thus, radiologists should be familiar with the ad­vantages and disadvantages of available imaging modalities, methods for dose reduction, radiation risks, and medicolegal risk management guidelines.