Diagnostic management of suspected acute pulmonary embolism in the postpartum period

Article Article scientifique Article Diagnostic management of suspected acute pulmonary embolism in the postpartum period eng 2026-05-19 author Bhangu Gurjeet Division of Hematology, University of British Columbia, Vancouver, BC, Canada. author Greutert Sophie Marie Division of Angiology and Hemostasis, Department of Medical Specialties, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland. 447339 author Robert-Ebadi Helia Division of Angiology and Hemostasis, Department of Medical Specialties, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland. 640824 Département de médecine (DEMED) author Kline Jeffrey Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI. author Righini Marc Philip 0000-0003-1211-2969 Division of Angiology and Hemostasis, Department of Medical Specialties, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland. 38989 Département de médecine (DEMED) author Penaloza Andrea Emergency Department, Cliniques Universitaires Saint Luc, UCLouvain, Bruxelles, Belgium. author Perrier Arnaud Division of Angiology and Hemostasis, Department of Medical Specialties, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland. 27944 Décanat et administration de la faculté de médecine (ADMED) author Ghanima Waleed Departments of Hemato-oncology and Research, Østfold hospital, Grålum, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. author Mallick Ranjeeta Ottawa Methods Center, Ottawa Hospital Research Institute, Ottawa, ON, Canada. author Takada Toshihiko Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands. author van Es Nick Department of Vascular Medicine, Amsterdam UMC; University of Amsterdam, Amsterdam, Netherlands; Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands. author Klok Frederikus A Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Netherlands. author Geersing Geert-Jan Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands. author Le Gal Grégoire Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. author Skeith Leslie Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: laskeith@ucalgary.ca. 10.1016/j.jtha.2026.05.010 42162739 1538-7836 https://linkinghub.elsevier.com/retrieve/pii/S1538783626003338 Background: Pregnancy and the postpartum period increase the risk of venous thromboembolism (VTE) including pulmonary embolism (PE), which is an important cause of maternal morbidity and mortality. While diagnostic strategies for suspected PE in pregnancy have evolved, postpartum patients remain underrepresented in research. Objective: To evaluate diagnostic strategies and the prevalence of PE among postpartum patients presenting to an acute care setting with suspected PE, using data from a previously published individual patient data meta-analysis (IPDMA). Methods: We analyzed 201 postpartum patients from six studies included in the IPDMA. Primary outcomes were PE prevalence and a description of the diagnostic tests used. Secondary outcomes included the performance of retrospectively calculated clinical decision rules (CDRs) including the revised Geneva score, pregnancy-adapted Geneva (PAG) score, and pulmonary embolism rule-out criteria (PERC), in combination with D-dimer testing and imaging. Results: Among 201 postpartum patients with suspected PE, the prevalence was 6.0% (95% CI, 2.9%-12.3%). The revised Geneva and PERC CDRs performed similarly to previously published data. Notably, 29% (29/100, 95% CI, 21%-39%) of postpartum patients had a negative D-dimer result, and none of those with a negative result were diagnosed with PE, regardless of the CDR used. Conclusions: The observed PE prevalence of 6.0% in this postpartum cohort underscores the need for evidence-based diagnostic pathways for physicians. Given that 29% of patients had a negative D-dimer and none were diagnosed with PE, diagnostic algorithms incorporating D-dimer testing could be applied in postpartum evaluations. D-dimer Postpartum Pulmonary embolism Dewey 616 56 Département de médecine 221 false 477 Maladie thromboembolique veineuse 808 319 Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) 585 Journal of thrombosis and haemostasis b9a76071-08fb-462f-91d0-4fc24031f75f Article (Published version) Public 1-s2.0-S1538783626003338-main.pdf 753821 application/pdf CC BY-NC-ND-4.0 d87e01315b2611838be1ae551d6c5f68e6e07650aa704268d909f69ca4bc8b5d openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Year	Views	Downloads

Diagnostic management of suspected acute pulmonary embolism in the postpartum period	Journal of thrombosis and haemostasis	2026	3	4
Thrombose veineuse profonde du membre inférieur : du diagnostic au traitement	Revue médicale suisse	2024	20	1
Inflammation périvasculaire transitoire de l’artère carotide : une cause rare de cervicalgie	Revue médicale suisse	2024	16	0

Archive ouverte UNIGE

Greutert, Sophie Marie