The occurrence of venous thromboembolism (VTE), which includes clots in the deep venous channels of the legs and abdomen, and pulmonary embolism is increased in pregnancy. VTE is one of the leading causes of maternal mortality resulting in 15% of maternal deaths reported in the United States between 2003 and 2011. A full discussion of the complexities involved with cause, diagnosis and treatment is beyond the scope of this short article. I will focus on diagnosis and the problems associated with radiation exposure during the testing process.
The diagnosis of pulmonary embolism often requires one or all of these tests: chest x-ray, lung scan and an angiogram performed by CT scan. The preferred imaging study in pregnancy is a lung scan. However, this study does not always give an undeniable positive result in which case the CT scan is needed.
The radiation dose that is considered safe for the mother and fetus is measured in something abbreviated as cGy. The upper limit of a safe dose is 5cGy. A chest x-ray plus a lung scan plus a CT scan together come to only a maximum of 0.1402cGy, well below the safety limit. If you are pregnant and a pulmonary embolism is suspected, I advise you to proceed with the necessary radiologic work up.
The treatment of VTE in pregnancy can pose additional problems. Not only is bleeding a problem, depending on the stage of pregnancy, but some of the drugs used may cause birth defects. You need advice from someone knowledgeable.
