Pregnancy: DVT/PE Investigation

Key points

• Suspected DVT in pregnancy: compression duplex ultrasound.
• Suspected PE: ECG and chest x-ray in ALL patients; if DVT symptoms/signs → compression duplex ultrasound first — if DVT confirmed, no further investigation needed, treat VTE.
• V/Q vs CTPA decided locally with patient and radiologist.
• CTPA slightly increases lifetime maternal breast cancer risk (up to 13.6%; background ~1/200); V/Q carries slightly higher childhood cancer risk (1/50,000 vs < 1/1,000,000 with CTPA).
• D-dimer is of limited use — often raised in pregnancy.

Decision points in this pathway

• Suspected DVT or PE?
• DVT symptoms/signs present?
• DVT confirmed?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.