566: DESCRIPTIVE ANALYSIS OF OBSTETRIC PATIENTS WITH PULMONARY EMBOLISM AT A SINGLE TERTIARY CENTER

Abstract

Introduction: Obstetric patients with pulmonary embolism (PE) are at higher risk of severe maternal morbidity and mortality. There is limited data validating current PE scoring systems in the obstetric population. We performed a descriptive study comparing the clinical characteristics and maternal and neonatal outcomes of the PERT consults in all of our female patients in reproductive age, by their pregnancy status. Methods: We identified all female patients in reproductive age (18 to 55) between 1/2019 to 5/2022, and divided by pregnancy status. Electronic medical records were used to collect clinical characteristics and treatment modalities. The primary outcome was survival at 30 days. Secondary outcomes included echocardiogram and CTA findings, admission vital signs, BOVA score procedural and neonatal outcomes. Univariable analysis was performed to compare characteristics and primary outcomes. Results: A total of 106 PERT consults were reported. 6 patients were pregnant. At the time of PE diagnosis the mean gestational age was 23w3d (SD). Two patients were delivered with 1 maternal death. Obstetric patients were younger than non-pregnant patients (33.8 vs. 41.9, p= 0.06). There was no statistical difference in right ventricular (RV) strain by CT (46% vs, p= 0.85), initial heart rate (102 vs. 111, p= 0.28), systolic blood pressure (102 vs. 119, p= 0.08), elevated troponin (50% vs. 61%, p= 0.59), or presence of massive PE (16.7% vs. 16%, p= 0.97). Standard Bova score points were also similar (2.2 vs. 2.1, p= 0.78) corresponding to a grade of 1, low risk. There were more low risk consults in the pregnant group (33.3% vs. 5%, p= 0.007). On initial TTE, there was no difference in RV dilation, function, RVSP, or TAPSE between the groups. Each group also had similar of rates transfer to ICU and interventions on arrival. Survival at 30 days was lower in the pregnant group (83.3% vs. 98%, p= 0.04). Conclusions: Despite similar demographic, hemodynamic, and TTE characteristics between all patients in reproductive age, our study suggest that obstetric patients with PE are at a higher risk of death. Indicating that traditional triage and management guidelines for patients with PE lack reproducibility in the obstetric population. New risk factors need to be identified for outcome predictors in obstetric patients.