A 31-year-old woman at 30 weeks' gestation presents with pleuritic chest pain and dyspnoea. Oxygen saturation is 94% on air, pulse is 112/min and

Question

A 31-year-old woman at 30 weeks' gestation presents with pleuritic chest pain and dyspnoea. Oxygen saturation is 94% on air, pulse is 112/min and chest radiograph is normal. Left calf is swollen and tender. She has no bleeding risk. What is the most appropriate next step in management?

Accepted Answer

Start low-molecular-weight heparin and arrange compression ultrasound of the leg

Answer

Request D-dimer and discharge if negative

Answer

Start warfarin because pregnancy increases thrombosis risk

Answer

Withhold anticoagulation until CT pulmonary angiography is completed

Answer

Use a direct oral anticoagulant as first-line therapy

Suspected pulmonary embolism in pregnancy with leg symptoms — SCE Acute Medicine MCQ

A 31-year-old woman at 30 weeks' gestation presents with pleuritic chest pain and dyspnoea. Oxygen saturation is 94% on air, pulse is 112/min and chest radiograph is normal. Left calf is swollen and tender. She has no bleeding risk. What is the most appropriate next step in management?