THE VALUE OF VENTILATION-PERFUSION IMAGING IN PREGNANCY

Pulmonary embolism (PE) is a major cause of maternal death during preg nancy. The aims of this retrospective study were to review 5 gears exp erience of ventilation-perfusion (V/Q) imaging in pregnancy, to evalua te the effect of the V/Q scan report on the referring clinician's use of anticoagulants and to monitor the course and outcome of pregnancy. 82 patients (aged 17-44 years, gestation 6-40 weeks) underwent V/Q ima ging for suspected PE, over a 5 year period. Modified PIOPED criteria were used to assess the probability of PE. 31 patients were shown to h ave normal scans (38%); 19 (23%) had low probability (LP) scans; 14 (1 7%) had intermediate probability (IF) scans and 18 (22%) had high prob ability (HP) scans for PE. Referring clinicians saw the reports and to ok action within 12 h. Anticoagulation was continued or started in 31 patients (all HP, 12 IP and 1 LP). Anticoagulation was considered unne cessary in 52 patients (all normal, 19 LP and 2 IP). None of the patie nts with normal or LP scans had documented PE during the follow-up per iod (median 25 months, range 3-60 months). No complications of anticoa gulation were observed and no adverse outcome of pregnancy were report ed. V/Q imaging is a valuable technique in the management of pregnant women suspected of having PE.