Diagnosis of Pulmonary Embolism During Pregnancy
Authors: Stephen Malnick, Lucy Kikayon
Journal: Annals of Internal Medicine (2019)

Letters16 July 2019Diagnosis of Pulmonary Embolism During PregnancyStephen Malnick, MA(Oxon), MSc, MBBS(Lond) and Lucy Kikayon, MDStephen Malnick, MA(Oxon), MSc, MBBS(Lond)Kaplan Medical Center, Rehovot, Israel (S.M., L.K.)Search for more papers by this author and Lucy Kikayon, MDKaplan Medical Center, Rehovot, Israel (S.M., L.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0191 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We believe that Righini and colleagues' article (1) discussing a strategy for diagnosis of PE in pregnancy has serious ethical limitations. Their study was done in 11 large medical centers in Switzerland and France with access to magnetic resonance imaging. Magnetic resonance pulmonary angiography is an attractive new tool that avoids radiation exposure and does not use nephrotoxic contrast agents. We believe that their study should have examined the use of this test as the diagnostic tool.The complications of computed tomography pulmonary angiography include the use of injected iodinated contrast (which has known renal complications and ...References1. Righini M, Robert-Ebadi H, Elias A, et al; CT-PE-Pregnancy Group. Diagnosis of pulmonary embolism during pregnancy. A multicenter prospective management outcome study. Ann Intern Med. 2018;169:766-73. [PMID: 30357273]. doi:10.7326/M18-1670 LinkGoogle Scholar2. van Mens TE, Scheres LJ, de Jong PG, et al. Imaging for the exclusion of pulmonary embolism in pregnancy. Cochrane Database Syst Rev. 2017;1:CD011053. [PMID: 28124411] doi:10.1002/14651858.CD011053.pub2 CrossrefMedlineGoogle Scholar3. Ohno Y, Higashino T, Takenaka D, et al. MR angiography with sensitivity encoding (SENSE) for suspected pulmonary embolism: comparison with MDCT and ventilation-perfusion scintigraphy. AJR Am J Roentgenol. 2004;183:91-8. [PMID: 15208117] CrossrefMedlineGoogle Scholar4. Good Clinical Practice Network. The Principles of ICH GCP. 2019. Accessed at https://ichgcp.net/2-the-principles-of-ich-gcp-2 on 10 November 2018. Google Scholar Author, Article, and Disclosure InformationAffiliations: Kaplan Medical Center, Rehovot, Israel (S.M., L.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0191. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnosis of Pulmonary Embolism During Pregnancy Marc Righini , Helia Robert-Ebadi , Antoine Elias , Olivier Sanchez , Emmanuelle Le Moigne , Jeannot Schmidt , Catherine Le Gall , Jacques Cornuz , Drahomir Aujesky , Pierre-Marie Roy , Céline Chauleur , Olivier T. Rutschmann , Pierre-Alexandre Poletti , Grégoire Le Gal , and Diagnosis of Pulmonary Embolism During Pregnancy Marc Righini and Grégoire Le Gal Diagnosis of Pulmonary Embolism During Pregnancy Steve Goodacre , Beverley Hunt , and Catherine Nelson-Piercy Metrics 16 July 2019Volume 171, Issue 2Page: 147-148KeywordsAngiographyComputed axial tomographyDisclosureLung and intrathoracic tumorsMagnetic resonance imagingPregnancyRadiation exposureSafetySpecificitySystematic reviews ePublished: 16 July 2019 Issue Published: 16 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...