Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study

Grégoire Le Gal, Geneviève Kercret, Khalil Ben Yahmed, Luc Bressollette, Helia Robert-Ebadi, Louise Riberdy, Patrick Louis, Aurélien Delluc, Marie-Luce Labalette, Mohamed Baba-Ahmed, Henri Bounameaux, Dominique Mottier, Marc Righini, EDVIGE Study Group, François Boehlen, François Becker, Dominique Bernard, Jean Broussaud, Paul Cirafici, Cécile de, Gail Sauteron, Philippe de Moerloose, Marie-Annick Direr, Catherine Duigou-Bihi, Pierre Fontana, Jacques Gestin, Salah Gueddi, Bruno Guias, Bruno Guichaoua, Patrice Hudo, Nathalie Journeaux, Raymond Kaczmarek, Dominique le Berre, Isabelle Leborgne, Marie-Pierre le Goc Pedelucq, Dominique le Menn Bureau, Fabrice le Thoer, Stéphanie Louis, Geneviève Madec Bougeard, Mario Maufus, Catherine Noel Morel, Karine Pichon, Emmanuel Plat, Laurent Pruvost, Philippe Quehe, Edith Rivoal, Eric Thulliez, Johny Vogel, Robert Wutschert, Grégoire Le Gal, Geneviève Kercret, Khalil Ben Yahmed, Luc Bressollette, Helia Robert-Ebadi, Louise Riberdy, Patrick Louis, Aurélien Delluc, Marie-Luce Labalette, Mohamed Baba-Ahmed, Henri Bounameaux, Dominique Mottier, Marc Righini, EDVIGE Study Group, François Boehlen, François Becker, Dominique Bernard, Jean Broussaud, Paul Cirafici, Cécile de, Gail Sauteron, Philippe de Moerloose, Marie-Annick Direr, Catherine Duigou-Bihi, Pierre Fontana, Jacques Gestin, Salah Gueddi, Bruno Guias, Bruno Guichaoua, Patrice Hudo, Nathalie Journeaux, Raymond Kaczmarek, Dominique le Berre, Isabelle Leborgne, Marie-Pierre le Goc Pedelucq, Dominique le Menn Bureau, Fabrice le Thoer, Stéphanie Louis, Geneviève Madec Bougeard, Mario Maufus, Catherine Noel Morel, Karine Pichon, Emmanuel Plat, Laurent Pruvost, Philippe Quehe, Edith Rivoal, Eric Thulliez, Johny Vogel, Robert Wutschert

Abstract

Objective: To assess the safety of using single complete compression ultrasonography in pregnant and postpartum women to rule out deep vein thrombosis.

Design: Prospective outcome study.

Setting: Two tertiary care centres and 18 private practices specialising in vascular medicine in France and Switzerland.

Participants: 226 pregnant and postpartum women referred for suspected deep vein thrombosis.

Methods: A single proximal and distal compression ultrasonography was performed. All women with a negative complete compression ultrasonography result did not receive anticoagulant therapy and were followed up for a three month period.

Main outcome measures: Symptoms of venous thromboembolism, second compression ultrasonography or chest imaging, a thromboembolic event, and anticoagulant treatment.

Results: 16 women were excluded, mainly because of associated suspected pulmonary embolism. Deep vein thrombosis was diagnosed in 22 out of the 210 included women (10.5%). 10 patients received full dose anticoagulation despite a negative test result during follow-up. Of the 177 patients without deep vein thrombosis and who did not receive full dose anticoagulant therapy, two (1.1%, 95% confidence interval 0.3% to 4.0%) had an objectively confirmed deep vein thrombosis during follow-up.

Conclusions: The rate of venous thromboembolic events after single complete compression ultrasonography in pregnant and postpartum women seems to be within the range of that observed in studies in the non-pregnant population. These data suggest that a negative single complete compression ultrasonography result may safely exclude the diagnosis of deep vein thrombosis in this setting.

Trial registration: clinicaltrials.gov NCT00740454.

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4789980/bin/legg003041.f1_default.jpg
Flow of participants through study

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Source: PubMed

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