Diagnostic value of a negative single complete compression ultrasound of the lower limbs to exclude the diagnosis of deep venous thrombosis in pregnant or postpartum women: a retrospective hospital-based study

Grégoire Le Gal, Anne-Marije Prins, Marc Righini, Caroline Bohec, Karine Lacut, Pierre Germain, Jean-Claude Vergos, Raymond Kaczmarek, Bruno Guias, Michel Collet, Luc Bressollette, Emmanuel Oger, Dominique Mottier
Thrombosis Research 2006, 118 (6): 691-7

OBJECTIVE: We aimed at determining whether a negative single complete compression ultrasonography (CUS) of the lower limbs veins is a safe and accurate diagnostic method to rule out the diagnosis of deep venous thrombosis in pregnant and early postpartum women.

DESIGN: Hospital-based retrospective study.

SETTING: The gynaecology and vascular ultrasound units of three general hospitals in western France.

PATIENTS: We identified from the hospitals databases all pregnant or up to three months postpartum women who underwent CUS for a suspicion of deep venous thrombosis between January 2002 and December 2004.

METHODS: Questionnaires were sent to all women with a negative CUS. Their medical records were also checked.

MAIN OUTCOME MEASURES: We assessed the three-month thromboembolic risk and its 95% percent confidence interval in women left untreated on the basis of a negative single complete CUS of the lower limbs.

RESULTS: During the study period, 162 pregnant or postpartum women underwent CUS for a suspicion of deep venous thrombosis. It was positive in 44 (27%). The 118 women who had a negative CUS were sent the questionnaire. Information about the three-month follow-up was found for 107 patients (91%). None of them experienced a thromboembolic event during follow-up: 0.0% (95% CI: 0.0-3.6).

CONCLUSIONS: Single complete CUS of lower limbs veins appears to be a safe method to rule out the diagnosis of deep venous thrombosis in pregnant or early postpartum women. This has to be confirmed by a prospective management study with a formal follow-up.

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