Document Detail


Assessment of the alveolar-arterial oxygen gradient as a screening test for pulmonary embolism in pregnancy.
MedLine Citation:
PMID:  20554265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to determine whether the alveolar-arterial (A-a) oxygen gradient is an adequate screening test for pulmonary embolism (PE) in pregnancy and postpartum. STUDY DESIGN: A chart review was performed at Tampa General Hospital. Patients who had a workup for a PE consisting of a computed tomography pulmonary angiogram and an arterial blood gas from 2002 to 2009 were included in the analysis. Sensitivity, specificity, and negative and positive predictive values were calculated. Additionally, common clinical signs and symptoms were assessed for their ability to accurately predict PE. RESULTS: Of 102 patients, there were 13 PEs (2 antepartum and 11 postpartum). The best sensitivity, specificity, and negative and positive predictive values for A-a gradients were 76.9%, 20.2%, 80.0%, and 11.5%, respectively. CONCLUSION: The A-a gradient is a poor screening test for PE in pregnancy and postpartum. Suspicion of PE should prompt early imaging studies to rapidly make the diagnosis and begin treatment.
Authors:
Aaron B Deutsch; Pamela Twitty; Katheryne Downes; Michael T Parsons
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Publication Detail:
Type:  Journal Article     Date:  2010-06-15
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  203     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2010-11-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  373.e1-4     Citation Subset:  AIM; IM    
Copyright Information:
Published by Mosby, Inc.
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, FL 33606, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Humans
Mass Screening
Oxygen / metabolism*
Predictive Value of Tests
Pregnancy
Pregnancy Complications / diagnosis*
Pulmonary Alveoli / metabolism*
Pulmonary Embolism / diagnosis*
Pulmonary Gas Exchange*
ROC Curve
Retrospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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