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.
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.


METHODS
Hospital-based retrospective study.


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


METHODS
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.


METHODS
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.
Le Gal
Grégoire
G
EA 3878 and Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France. gregoire.legal@chu-brest.fr
Prins
Anne-Marije
AM
Righini
Marc
M
Bohec
Caroline
C
Lacut
Karine
K
Germain
Pierre
P
Vergos
Jean-Claude
JC
Kaczmarek
Raymond
R
Guias
Bruno
B
Collet
Michel
M
Bressollette
Luc
L
Oger
Emmanuel
E
Mottier
Dominique
D
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging*; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*