Suspected pulmonary embolism

[starlightmagic]

Following blood tests I have a suspected pulmonary embolism, doctors have given me 48 hours to decide if I want a ct scan to diagnose or whether to see how it goes. They are happy if it IS an embolism then it’s small. I am 35 weeks pregnant and I don’t know what to do

I've been in your position and was found to have multiple pe's at 34 weeks pregnant. I had a VQ scan which exposes you to lower radiation I believe. Has that been suggested? When it comes to the risks, overall having a pe is obviously a risk to both you and your baby and if it is being offered then the doctors must think the risks are worth a diagnosis? Having said that if they are considering waiting and think it is a small pe then they can't be too concerned. Have they given the option of treatment without a full diagnosis to get you safely through the next few weeks?

They didn’t offer blood thinners at this stage, I’m really not sure I asked enough questions at the time :( I might call midwife tomorrow and ask her opinion?
I asked if we got to the stage of giving birth would it cause a problem with the extra stress on lungs. Doctor seemed to think if we get that far down the line then it won’t be a problem

I was due to be induced at 37 weeks due to other complications but the decision was made to get me to go as long and possible and just monitor me carefully as there was concern about the blood clots effect on my breathing and risk of dislodging during birth. (I did have a lot of clots though so it might make a difference).

I would definitely discuss it further. If they would consider blood thinners without the scan its probably a good option. It took me seeing a different doctor than the one initially diagnosing to actually talk though everything to make me realise that for me the scan was worth it. Write down your questions, see if the midwife can help and if not speak to someone at the hospital before agreeing yo a scan. Hope you get sorted soon.

If a PE is suspected, you should be on blood thinners until they’ve proven its NOT a PE, not wait for a scan to prove there is one. The nature of clots means that even if you have a small one now, they can grow or you can develop more

I would avoid the CT scan because of the radiation - you should be offered a VQ scan instead, which is much safer in pregnancy

The risk is to your breasts - the rapidly multiplying tissue in pregnancy gives you higher risk of future breast cancer of exposed to radiation now. There’s actually quite minimal risk to the baby (although obviously still best avoided)

You need to talk to a doctor again today, your midwife won’t be able to help here. Refer them to the RCOG guidelines for PE in pregnancy

If they’re suspicious enough to put you at risk with a CT scan, they should be treating you

(I am a doctor)