Pregnancy-associated pulmonary embolism is one of the leading causes of maternal mortality. Diagnosis of pulmonary embolism in pregnancy is challenging, with symptoms of pulmonary embolism mimicking those of pregnancy. Several key components such as clinical prediction tools, risk stratification, laboratory tests, and imaging widely used for diagnosis of pulmonary embolism in the non-pregnant population show limitations for diagnosis in pregnancy. Further, because of the difficulty of studying pregnant patients, high-quality research evaluating the performance of these diagnostic components in pregnancy is scarce. Seven international medical society guidelines present clinical diagnostic pathways for evaluation of pulmonary embolism in pregnancy that show conflicting recommendations on the use of these diagnostic components. This Review assesses all key components of diagnostic clinical pathways recommended by guidelines for evaluation of pulmonary embolism in pregnancy, reviews current evidence, compares the guideline recommendations with respect to each key component, and provides our preferred diagnostic pathway. It provides the guidelines and available data needed for informed decision making to diagnose pulmonary embolism in pregnancy.

中文翻译：

---

国际社会指南对妊娠期可疑肺栓塞的诊断比较。

妊娠相关的肺栓塞是孕产妇死亡的主要原因之一。妊娠期肺栓塞的诊断具有挑战性，肺栓塞的症状类似于妊娠期的症状。临床预测工具，风险分层，实验室测试和影像学等广泛用于诊断非妊娠人群肺栓塞的关键要素显示了对妊娠诊断的局限性。此外，由于难以研究孕妇，因此缺乏评估这些诊断成分在妊娠中的性能的高质量研究。七项国际医学会指南提出了评估妊娠肺栓塞的临床诊断途径，这些途径对使用这些诊断成分提出了相互矛盾的建议。这篇综述评估了妊娠肺栓塞评估指南所推荐的诊断性临床途径的所有关键组成部分，回顾了当前证据，比较了每个关键成分的指导性建议，并提供了我们首选的诊断途径。它提供了指导和诊断妊娠肺栓塞所需的可用数据，以进行明智的决策。