Cargando…
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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1785119664331816960 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10569988 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT parksannal excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT fazilimasarret excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT astonvalerie excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT portertflint excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT branchdware excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT wollerscottc excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT snowgregoryl excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound AT stevensscottm excludingpregnancyassociateddeepveinthrombosiswithwholelegultrasound |