Questionnaire/history:

Chest pain?

- Pleuritic (53%)?

- Non-pleuritic (21%)?

Shortness of breath?

- At rest (54%)?

- On exertion (51%)?

Haemoptysis (7%)?

Cough (9%)?

Syncope (5%)?

Palpitations - 13%

Temperature >37.5 - 8%

Tachycardia (>100 in T1-2 or >110 T3) - 30%

Tachypnoea RR > 24 - 10%

SpO2 < 94% (15%)?

Key risk factors?

Obesity?

- BMI > 30 (4x VTE risk increase)

Age?

- > 45 years?

Long-haul travel?

Past medical history?

Current medication?

Known drug allergies?

Management:

Any pregnant (or postpartum) woman with suspected PE should be admitted to hospital for further investigations:

- Duplex scan of the deep veins (to look for DVT) and if no signs of DVT but PE is suspected further imaging with either CTPA or VQ scan

RCOG risk assessment for VTE

Score ≥ 4: consider thromboprophylaxis from 1st trimester

Score 3: consider thromboprophylaxis from 28 weeks

Resource(s):

BJGP 2022; 72

MBRRACE-UK 2021

RCOG VTE management 2015