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Clinical Trial
. 2012 Apr 24:344:e2635.
doi: 10.1136/bmj.e2635.

Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study

Grégoire Le Gal  1 , Geneviève Kercret, Khalil Ben Yahmed, Luc Bressollette, Helia Robert-Ebadi, Louise Riberdy, Patrick Louis, Aurélien Delluc, Marie-Luce Labalette, Mohamed Baba-Ahmed, Henri Bounameaux, Dominique Mottier, Marc Righini; EDVIGE Study Group
Collaborators, Affiliations
Clinical Trial

Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study

Grégoire Le Gal et al. BMJ. .

Abstract

Objective: To assess the safety of using single complete compression ultrasonography in pregnant and postpartum women to rule out deep vein thrombosis.

Design: Prospective outcome study.

Setting: Two tertiary care centres and 18 private practices specialising in vascular medicine in France and Switzerland.

Participants: 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.

Main outcome measures: 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.

Trial registration: clinicaltrials.gov NCT00740454.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Flow of participants through study
See this image and copyright information in PMC

References

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