A Review of the Use of CT Pulmonary Angiography in Pregnant and Postpartum Patients at an Academic Centre
| dc.contributor.author | Herbst, Wilhelm | |
| dc.contributor.supervisor | Zamparini, Jarrod | |
| dc.contributor.supervisor | Moodley, Halvani | |
| dc.contributor.supervisor | Bhoora, Shastra | |
| dc.date.accessioned | 2024-11-18T10:25:35Z | |
| dc.date.available | 2024-11-18T10:25:35Z | |
| dc.date.issued | 2024 | |
| dc.description | A research project submitted in fulfillment of the requirements for the degree of Master of Medicine (MMed) in Internal Medicine to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2024 | |
| dc.description.abstract | The most common cause of maternal death during pregnancy and the puerperium in developed countries is venous thromboembolic events, including pulmonary embolism (PE).1 The risk for venous thromboembolism (VTE) is significantly increased during pregnancy and the postpartum period, as these patients are in a state of hypercoagulability, are prone to venous stasis and may have superimposed endothelial damage.2 Data has shown that women have a 5-fold increased risk of developing VTE during pregnancy, as compared to their non-pregnant counterparts,3 and, according to a Scottish study, the incidence of antenatal VTE has increased over the last 26 years.4 Past research has observed an incidence of PE in pregnant or postpartum women of 3 in 10,0002,5, with one death in every 100,000 deliveries.6 Some studies have found an absolute incidence of VTE in pregnancy to be as high as 1 to 2 cases per 1000 pregnancies3; a risk that is nearly five times higher than that among non-pregnant women.7 More than half the cases of VTE in pregnancy occur in the first trimester, before 20 weeks’ gestation.5 Yet, 80% of VTE cases in the postpartum period have been observed to occur within the first 3 weeks following delivery.8 Recent studies haveM revealed a raised relative risk (however low absolute risk) that remains up to 12 weeks following delivery.9 A large meta-analysis and systematic review of seventeen studies, which included 25,339 patients, found that 2% of patients presenting to the emergency department with symptoms suggestive of PE, were pregnant.10 This translates to a 12.4% positivity rate for VTE in nonpregnant patients, compared with 4.1% in pregnant patients.10 The perceived lower yield of confirmed VTE in pregnancy can be ascribed to the low threshold physicians have to scan pregnant patients, due to the high risk of devastating sequelae of PE in pregnancy | |
| dc.description.submitter | MM2024 | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.citation | Herbst, Wilhelm . (2024). A Review of the Use of CT Pulmonary Angiography in Pregnant and Postpartum Patients at an Academic Centre [Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace. | |
| dc.identifier.uri | https://hdl.handle.net/10539/42664 | |
| dc.language.iso | en | |
| dc.publisher | University of the Witwatersrand, Johannesburg | |
| dc.rights | © 2024 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg. | |
| dc.school | School of Clinical Medicine | |
| dc.subject | Venous thromboembolism | |
| dc.subject | CT Pulmonary Angiography | |
| dc.subject | Pregnant and Postpartum Patients | |
| dc.subject | UCTD | |
| dc.subject.other | SDG-3: Good health and well-being | |
| dc.title | A Review of the Use of CT Pulmonary Angiography in Pregnant and Postpartum Patients at an Academic Centre | |
| dc.type | Dissertation |