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

Thromb Res. 2006;118(6):691-7. doi: 10.1016/j.thromres.2005.12.004. Epub 2006 Jan 18.

Abstract

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Lower Extremity / blood supply
  • Lower Extremity / diagnostic imaging*
  • Postpartum Period
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnostic imaging*
  • Retrospective Studies
  • Ultrasonography
  • Venous Thrombosis / diagnostic imaging*