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Lancet. 2010 Feb 6;375(9713):500-12. doi: 10.1016/S0140-6736(09)60996-X. Epub 2009 Nov 2.

Pulmonary embolism in pregnancy.

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  • 1Department of Medicine, The Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI 02905, USA.


Pulmonary embolism (PE) is the leading cause of maternal mortality in the developed world. Mortality from PE in pregnancy might be related to challenges in targeting the right population for prevention, ensuring that diagnosis is suspected and adequately investigated, and initiating timely and best possible treatment of this disease. Pregnancy is an example of Virchow's triad: hypercoagulability, venous stasis, and vascular damage; together these factors lead to an increased incidence of venous thromboembolism. This disorder is often suspected in pregnant women because some of the physiological changes of pregnancy mimic its signs and symptoms. Despite concerns for fetal teratogenicity and oncogenicity associated with diagnostic testing, and potential adverse effects of pharmacological treatment, an accurate diagnosis of PE and a timely therapeutic intervention are crucial. Appropriate prophylaxis should be weighed against the risk of complications and offered according to risk stratification.

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