Even though venous thromboembolism is a leading cause of maternal mortality in high-income countries, there are limited high-quality data to assist clinicians with the management of pulmonary embolism in this patient population. Diagnosis, prevention, and treatment of pregnancy-associated pulmonary embolism are complicated by the need to consider fetal, as well as maternal, well-being. Recent studies suggest that clinical prediction rules and D-dimer testing can reduce the need for diagnostic imaging in a subset of patients. Low-molecular-weight heparin is the preferred anticoagulant for both prophylaxis and treatment in this setting. Direct oral anticoagulants are contraindicated during pregnancy and in breastfeeding women. Thrombolysis or embolectomy should be considered for pregnant women with pulmonary embolism complicated by hemodynamic instability. Treatment of pregnancy-associated pulmonary embolism should be continued for at least 3 months, including 6 weeks postpartum. Management of anticoagulants at the time of delivery should involve a multidisciplinary individualized approach that uses shared decision making to take patient and caregiver values and preferences into account.

尽管静脉血栓栓塞是高收入国家孕产妇死亡的主要原因，但帮助临床医生管理这一患者人群肺栓塞的高质量数据有限。妊娠相关肺栓塞的诊断、预防和治疗由于需要考虑胎儿以及母体的健康状况而变得复杂。最近的研究表明，临床预测规则和 D-二聚体测试可以减少一部分患者对诊断成像的需求。在这种情况下，低分子量肝素是预防和治疗的首选抗凝剂。怀孕期间和哺乳期妇女禁用直接口服抗凝剂。对于合并血流动力学不稳定的肺栓塞的孕妇，应考虑溶栓或栓子切除术。妊娠相关肺栓塞的治疗应持续至少 3 个月，包括产后 6 周。分娩时的抗凝剂管理应涉及多学科个体化方法，该方法使用共同决策来考虑患者和护理人员的价值观和偏好。