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Exploring pregnant individuals’ counseling needs regarding urgent imaging to rule out pulmonary embolism
Author(s): ,
Isabelle Malhamé
Affiliations:
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
Isabelle Malhamé, Department of Medicine, McGill University Health Centre, 1001 Décarie Boulevard, D05.5839.3, Montréal, Québec H4A 3J1, Canada.
,
Ning-Zi Sun
Affiliations:
Institute for Health Sciences Education, McGill University, Montréal, Québec, Canada
,
Linda Snell
Affiliations:
Institute for Health Sciences Education, McGill University, Montréal, Québec, Canada
,
Alexandra de Pokomandy
Affiliations:
Department of Family Medicine, McGill University, Montréal, Québec, Canada
,
Vicky Tagalakis
Affiliations:
Centre for Clinical Epidemiology, Lady Davis Institute of the Jewish General Hospital, Montréal, Québec, Canada
,
Sarah St-Georges
Affiliations:
Department of Obstetrics and Gynecology, McGill University Health Centre, Montréal, Québec, Canada
,
Amal Bessissow
Affiliations:
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
,
Stéphanie Lam
Affiliations:
Department of Diagnostic Radiology, McGill University Health Center, Montréal, Québec, Canada
,
Karen Wou
Affiliations:
Department of Obstetrics and Gynecology, McGill University Health Centre, Montréal, Québec, Canada
,
Antony Robert
Affiliations:
Department of Emergency Medicine, McGill University Health Centre, Montréal, Québec, Canada
,
Maral Koolian
Affiliations:
Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada
,
Camille Simard
Affiliations:
Centre for Clinical Epidemiology, Lady Davis Institute of the Jewish General Hospital, Montréal, Québec, Canada
,
Sandrine Hamel
Affiliations:
Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada
Suzie Ouellet
Affiliations:
Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada
ISTH Academy. Malhame I. 02/01/24; 417425
Dr. Isabelle Malhame
Dr. Isabelle Malhame
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Background

Computed tomography pulmonary angiogram and lung scintigraphy with ventilation/perfusion scan are needed to diagnose pulmonary embolism (PE) in pregnancy. Their associated ionizing radiation doses are considered safe in pregnancy. A standardized patient information tool may improve patient counseling and reduce testing hesitancy.

Objectives

In this context, we sought to address 1) what patients want to know before undergoing these tests and 2) how they want the information to be provided to them.

Methods

We used a qualitative descriptive methodology. We recruited pregnant participants at the McGill University Health Center in Montreal, Canada. Structured interviews explored information needs about PE and diagnostic imaging for PE. The interview transcripts’ themes were analyzed with a hybrid deductive and inductive approach.

Results

Of 21 individuals approached, 20 consented to participate. Four had been previously investigated for PE. Participants requested information about the risks associated with PE and radiation and their effects on maternal and fetal health. They preferred for radiation doses to be presented in comparison with known radiation thresholds for fetal harm. They suggested that a written tool should be developed using an accessible language. Participants also indicated that the tool would be integrated into their decision-making process, emphasizing a lower risk tolerance for their fetus than for themselves.

Conclusion

This single-center group of pregnant patients wished to be informed about the risks of PE and radiation associated with imaging. A written tool could help put information into context and facilitate decision making. These new insights may be used to inform counseling.

Abstract

Diagnosing pulmonary embolism during pregnancy may be delayed by concerns for radiation. We interviewed pregnant individuals to understand their informational needs about these tests. Participants wished to be informed on the risks of pulmonary embolism and radiation exposure. A written tool could help put information into context and facilitate decision making.

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