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Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound

BACKGROUND: Deep vein thrombosis (DVT) is common in pregnancy, yet data are limited on the best diagnostic strategies in pregnant patients suspected of DVT. OBJECTIVES: We conducted a prospective cohort study to evaluate the rate of symptomatic DVT in the 90 days after a negative whole-leg compressi...

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Autores principales: Parks, Anna L., Fazili, Masarret, Aston, Valerie, Porter, T. Flint, Branch, D. Ware, Woller, Scott C., Snow, Gregory L., Stevens, Scott M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569988/
https://www.ncbi.nlm.nih.gov/pubmed/37840688
http://dx.doi.org/10.1016/j.rpth.2023.102202
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author Parks, Anna L.
Fazili, Masarret
Aston, Valerie
Porter, T. Flint
Branch, D. Ware
Woller, Scott C.
Snow, Gregory L.
Stevens, Scott M.
author_facet Parks, Anna L.
Fazili, Masarret
Aston, Valerie
Porter, T. Flint
Branch, D. Ware
Woller, Scott C.
Snow, Gregory L.
Stevens, Scott M.
author_sort Parks, Anna L.
collection PubMed
description BACKGROUND: Deep vein thrombosis (DVT) is common in pregnancy, yet data are limited on the best diagnostic strategies in pregnant patients suspected of DVT. OBJECTIVES: We conducted a prospective cohort study to evaluate the rate of symptomatic DVT in the 90 days after a negative whole-leg compression ultrasound (CUS) in pregnant women presenting with DVT symptoms. METHODS: In this prospective cohort study, we enrolled pregnant patients suspected of DVT between 2011 and 2019 who were referred to the vascular imaging laboratory at a tertiary care center and had anticoagulation held after a negative whole-leg CUS. Primary outcome was objectively confirmed DVT or pulmonary embolism or death due to venous thromboembolism (VTE). RESULTS: Whole-leg CUS yielded normal results in 186 patients (97.9%) and identified DVT in 4 (2.1%). The mean age was 30 and 164 were White. Among the 186 patients with a negative, initial whole-leg CUS who did not receive anticoagulation, there were 2 DVT events identified over the 90-day follow-up period, for an overall rate of 1.1% (95% CI: 0.2-3.4%). The study was terminated before full planned accrual for administrative reasons. CONCLUSION: The rate of symptomatic DVT is low in pregnant patients who have a single, negative whole-leg CUS and did not receive anticoagulation. Adequately powered studies should prospectively assess whole-leg CUS in a larger population alone and in combination with pre-test probability scores and/or D-dimer to determine its role in the evaluation of suspected DVT in pregnancy.
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spelling pubmed-105699882023-10-14 Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound Parks, Anna L. Fazili, Masarret Aston, Valerie Porter, T. Flint Branch, D. Ware Woller, Scott C. Snow, Gregory L. Stevens, Scott M. Res Pract Thromb Haemost Original Article BACKGROUND: Deep vein thrombosis (DVT) is common in pregnancy, yet data are limited on the best diagnostic strategies in pregnant patients suspected of DVT. OBJECTIVES: We conducted a prospective cohort study to evaluate the rate of symptomatic DVT in the 90 days after a negative whole-leg compression ultrasound (CUS) in pregnant women presenting with DVT symptoms. METHODS: In this prospective cohort study, we enrolled pregnant patients suspected of DVT between 2011 and 2019 who were referred to the vascular imaging laboratory at a tertiary care center and had anticoagulation held after a negative whole-leg CUS. Primary outcome was objectively confirmed DVT or pulmonary embolism or death due to venous thromboembolism (VTE). RESULTS: Whole-leg CUS yielded normal results in 186 patients (97.9%) and identified DVT in 4 (2.1%). The mean age was 30 and 164 were White. Among the 186 patients with a negative, initial whole-leg CUS who did not receive anticoagulation, there were 2 DVT events identified over the 90-day follow-up period, for an overall rate of 1.1% (95% CI: 0.2-3.4%). The study was terminated before full planned accrual for administrative reasons. CONCLUSION: The rate of symptomatic DVT is low in pregnant patients who have a single, negative whole-leg CUS and did not receive anticoagulation. Adequately powered studies should prospectively assess whole-leg CUS in a larger population alone and in combination with pre-test probability scores and/or D-dimer to determine its role in the evaluation of suspected DVT in pregnancy. Elsevier 2023-09-14 /pmc/articles/PMC10569988/ /pubmed/37840688 http://dx.doi.org/10.1016/j.rpth.2023.102202 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Parks, Anna L.
Fazili, Masarret
Aston, Valerie
Porter, T. Flint
Branch, D. Ware
Woller, Scott C.
Snow, Gregory L.
Stevens, Scott M.
Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title_full Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title_fullStr Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title_full_unstemmed Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title_short Excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
title_sort excluding pregnancy-associated deep vein thrombosis with whole-leg ultrasound
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569988/
https://www.ncbi.nlm.nih.gov/pubmed/37840688
http://dx.doi.org/10.1016/j.rpth.2023.102202
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