Place of scintigraphy in the diagnosis of pulmonary embolism in pregnant women - About 17 cases

Introduction. - Pulmonary embolism in pregnant women is a deadly disease; its diagnosis is based on specific algorithms. The lung scan is one of the recommended diagnostic suspicion in further investigations. Material and methods. - Retrospective study of a series of cases of pulmonary embolism in the period pre-partum and post-partum pregnant women collected during 3 years, from January 2010 to January 2013, at the reanimation department maternity Souissi in Rabat. Results. - Seventeen cases of pulmonary embolism pre- and post-partum. The age ranged between 21 and 37 years (mean age 30 years). Four EP post-partum were recorded with 13 cases of EP pre-partum whose mean gestational age was 30 SA. Several risk factors were found: 7 cases obesity, 4 cases cesarean section, 3 cases of varicose veins, 2 cases of endometritis, 1 case of twin pregnancy, 1 case of gestational hypertension and 1 case of alitement. The first reason for consultation was respiratory distress (12 cases), followed by chest pain (9 cas) and palpitations (6 cas). Lung scintigraphy performed in 14 patients' objective 9 cases of perfusion defect, 4 cases of normal scan and 1 case of massive PE. No deaths or recurrences have been reported. Conclusion. - Pregnancy and the post-partum period are at high risk of thromboembolic events due to physiological changes. The diagnostic approach is now well codified with scores of clinical and paraclinical probability. The lung scintigraphy can be a method of choice. Hybrid imaging is a good alternative for diagnostic performance. (authors)