Any professionals out there to advise on VQ scan whilst pregnant?

[IcouldstillbeJoseph]

I'm 17 wks preg, 2nd preg. No risk factors for PE other than pregnancy.
Saw GP 2 weeks ago with persistent cough, and had coughed up small amount of blood-stained mucous. Started antibiotics - no huge improvement in cough but mucous now white rather than green. No more blood after that one episode.
Then, this Monday developed pleuritic pain. Went back to gp and was found to be tachy at 140 ish - had normal ECG there but was sent into hospital. Had another ECG which showed sinus tachy but otherwise fine. I am very short of breath and find it hard to complete sentences. Can feel I'm still tachycardic. Had fbc, crp, troponin - all normal (I don't feel infected, just painful chest and sob). Had chest xray (despite not really wanting it as preg) all normal.
Was sent home on clexane and have VQ scan tomorrow.
The thing is - I just really don't believe I have a PE. I've had no DVT symptoms or anything. I'm thinking the pain is just pleurisy following chest infection and sob etc related to that?
I'm a MW and don't want to have unnecessary VQ scan when I dont really feel it's indicated?

From what you've said you have more than enough reason to have investigations for a PE, as I'm sure you know that really in your heart of hearts. PEs are tricky to diagnose without definitive testing and a vq scan is a better option than a CTPA, at least you can wear a lead skirt for some protection. If your tachycardic, sob and have pleuritic chest pain with a normal cxr then PE is certainly the most likely diagnosis.

If it were me I'd have the scan. If you have a PE you'll need anti coagulation for the rest of your pregnancy and beyond or there is very substantial risk, as you know, and anything threatening to you will threaten the baby.

(doc in anaesthesia and ITU) but can't give you an obstetric opinion.

Very best of luck and I hope it all comes back clear.

You will only be given a half dose of the radiopharmaceuticals as you are pregnant so your radiation exposure will be reduced that way. The radiopharmaceuticals are very specifically targetted to your lungs, too. Certainly not all departments would have a lead skirt for you though, as marmite is suggesting; given the direction the small amount of radiation going through your uterus will be coming from and the fact that the radiation is not delivered in a short burst it, would make little difference imo and our hospital don't use them. I know ionising radiation in pregnancy is best avoided unless you need it, but you will only be receiving one if both your clinicians and the nuclear medicine department both truly feel it is in your best interests. Wishing you all the best and hoping for a negative scan.

Sorry, should have said, I work in medical physics.

Thank you both - really wasn't expecting any replies - I underestimate MN obviously...
My gp called earlier to check on me and as it sounded like a breathless, dirty phonecall (my side only of course) I've just been summoned to the surgery again.
Remain tachy at 127. But sats fine.
I'm sure scan will be totally normal. But she reiterated so far down the line now thinking it's a PE then really should have scan. She agreed she didn't think it was though!

Hi,

I am a GP. If you were my patient I would definitely be sending you in for a scan with that history and tachycardia - and you don'y need any DVT symptoms to get a PE.

Remember all medics think there is nothing wrong with them ever despite evidence to the contrary - but that is not safe!

Best of luck.

I'm a GP too - and also 34w pregnant, if I were you with that history I would definitely want a vq scan, got to be suspicious of PE when pregnant especially. Hope it will all be negative and just settle down.

Well I had bi lateral PEs in pregnancy and was insisting that I was just out of breath as pregnant with twins. I was really cross when my midwife sent me to the hospital as it was an hour away and I felt it was a total waste of time.

I couldn't have a VQ as the ash cloud prevented the isotope (or whatever it is!!) being flown in, which was apparently done daily, so ended up with a chest x ray and then a CT scan instead. I was assured it was all safe in pregnancy though.

I spoke to my consultant obstetrician last night and she has given me 'a talking to'! She is also arranging an echo for tomorrow too.
Feeling quite grateful now as the pain has woken me up. Still, not so bad that I can't waste time on MN....

To anyone out there who responded and may care...
Thank heaven I went to VQ scan, was admitted to ITU with raging pneumonia after collapsing. So no PE after all but still shit!
Dont think I've ever felt closer to death!

Really sorry to hear you developed pneumonia, I hope you are much better now or at least on the mend?

Sounds terrible - thank goodness you went for the scan. Wishing you all the very best, and get well soon.

Thank you. Iv abx not having the speedy effect I was hoping for but I dont feel like death is imminent anymore. Maintaining SATS on 5l rather than 12 so that's better. Well enough to waste time on MN from my hospital bed!
I can see why old people die of this..... melodramatic

Glad to hear you are improving! Wishing you a very speedy recovery and a lovely, boring and straightforward pregnancy from here on.

Sorry to hear you're so poorly but very glad you're in the right place getting the treatment you need. Wish you a very quick and uneventfully recovery.