title: Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study.
abstract: OBJECTIVE
  To assess the safety of using single complete compression ultrasonography in pregnant and postpartum women to rule out deep vein thrombosis.
  
  
  METHODS
  Prospective outcome study.
  
  
  METHODS
  Two tertiary care centres and 18 private practices specialising in vascular medicine in France and Switzerland.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  clinicaltrials.gov NCT00740454.
authors.affiliation: INSERM CIC 05-02, Centre Hospitalier Universitaire de la Cavale Blanche, Brest, France. gregoire.legal@chu-brest.fr
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.forename: Geneviève
authors.initials: G
authors.lastname: Kercret
authors.forename: Khalil
authors.initials: K
authors.lastname: Ben Yahmed
authors.forename: Luc
authors.initials: L
authors.lastname: Bressollette
authors.forename: Helia
authors.initials: H
authors.lastname: Robert-Ebadi
authors.forename: Louise
authors.initials: L
authors.lastname: Riberdy
authors.forename: Patrick
authors.initials: P
authors.lastname: Louis
authors.forename: Aurélien
authors.initials: A
authors.lastname: Delluc
authors.forename: Marie-Luce
authors.initials: ML
authors.lastname: Labalette
authors.forename: Mohamed
authors.initials: M
authors.lastname: Baba-Ahmed
authors.forename: Henri
authors.initials: H
authors.lastname: Bounameaux
authors.forename: Dominique
authors.initials: D
authors.lastname: Mottier
authors.forename: Marc
authors.initials: M
authors.lastname: Righini
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging*; D010690:Phlebography; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*
chemical_list: D000925:Anticoagulants