title: [Analysis of the anatomical sites of 172 lower-limb venous thromboses occurring in a hormonal context in 996 young women; impact of the duplex-Doppler exploration].
abstract: OBJECTIVE
  To analyze localizations of duplex ultrasonography-diagnosed lower-limb venous thrombosis in young women in hormonal periods in order to optimize the ultrasound exploration.
  
  
  METHODS
  From 42,018 standardized ultrasonography report forms, incremented in a database (January 2001 - July 2013), those performed for a first diagnosis of venous thrombosis in women ≤ 45 years were selected (n = 996). Among those, diagnosed venous thrombosis (n = 172) were classified into three groups: oral contraception (n = 74), pregnancy (n = 39) and post-partum period (n = 59). Clinical symptoms and thrombosis distribution were analyzed.
  
  
  RESULTS
  In the contraception group, pulmonary symptoms at presentation were much more frequent than in the obstetrical group: 69% vs 20% (P < 0.001). The thrombosis was limited to the iliac veins in 31% (23/74) and to the left internal iliac vein in six patients. During pregnancy, the thrombosis was limited to the iliac veins in 28% (11/39), and to the left internal iliac vein in two patients. In the post-partum period, superficial venous thromboses were found more frequently (37/59). Among the 22 deep venous thromboses, nine were limited to the proximal segment, including four in the vena cava coming from a right ovarian vein thrombosis.
  
  
  CONCLUSIONS
  Duplex ultrasonography in young women taking oral contraception, as during pregnancy, must target iliac venous segments, especially on the left side, otherwise one thrombosis out of three may be missed; in the post-partum period, the inferior vena cava and superficial veins are to be explored too.
authors: Laboratoire des explorations fonctionnelles, CHU de la Côte-de-Nacre, avenue de la Côte-de-Nacre, 14033 Caen cedex, France. Electronic address: mtb.angio@wanadoo.fr.
authors: M-T
authors: MT
authors: Barrellier
authors: Service de médecine vasculaire, CHU de la Côte-de-Nacre, 14033 Caen cedex, France.
authors: S
authors: S
authors: Nativelle
authors: Unité biostatistique et recherche clinique, CHU de la Côte-de-Nacre, 14033 Caen cedex, France.
authors: E
authors: E
authors: Lacaze
authors: Unité biostatistique et recherche clinique, CHU de la Côte-de-Nacre, 14033 Caen cedex, France.
authors: R
authors: R
authors: Morello
authors: Service de médecine vasculaire, CHU de la Côte-de-Nacre, 14033 Caen cedex, France.
authors: C
authors: C
authors: Le Hello
mesh_terms: D000328:Adult; D003278:Contraceptives, Oral, Hormonal; D005260:Female; D006801:Humans; D007084:Iliac Vein; D007866:Leg / Q000098:blood supply*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000473:pathology*; D011644:Puerperal Disorders / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D003278:Contraceptives, Oral, Hormonal
keywords: Contraception œstroprogestative; Duplex ultrasonography; Grossesse; Oral contraception; Pregnancy; Thrombose veineuse; Venous thrombosis; Écho-Doppler veineux