YEARS-Adapted Algorithm for PE in Pregnancy
Pregnancy-adapted YEARS algorithm (van der Pol 2019, Artemis study). Three YEARS items + D-dimer threshold that varies with item count. Safely excludes PE in 39% without imaging.
Score interpretation
No YEARS item and D-dimer < 1000 ng/mL, or ≥ 1 item and D-dimer < 500 ng/mL.
→ No imaging required. Clinical follow-up. Document shared decision and 3-month outcome reassurance per Artemis trial protocol.
D-dimer at or above the threshold for the number of YEARS items.
→ If there are signs of DVT, compression duplex ultrasound first; if it confirms DVT, treat without CTPA. Otherwise CTPA or V/Q scan by local protocol (V/Q carries a slightly higher childhood cancer risk, CTPA a higher maternal breast cancer risk; both very small). Give therapeutic LMWH until PE is excluded unless strongly contraindicated (RCOG GTG 37b).
Interpretation bands for the YEARS-pregnancy. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Methotrexate (Ectopic) · Antimetabolite (Ectopic Pregnancy Management)
- Hydralazine (IV — Acute Hypertension in Pregnancy) · Vasodilator (Antihypertensive)
- Methyldopa (Chronic Hypertension in Pregnancy) · Centrally Acting Antihypertensive
- Enoxaparin (VTE in Pregnancy) · Low Molecular Weight Heparin (LMWH) — VTE Prophylaxis/Treatment
- Folic Acid (Pre-conception and Pregnancy) · Vitamin / Neural Tube Defect Prevention
- Ferric Carboxymaltose (IV Iron — Pregnancy) · IV Iron Preparation — Iron Deficiency Anaemia in Pregnancy
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
