Your browser doesn't support javascript.
loading
Diagnostic strategies in postpartum individuals with suspected venous thromboembolism: A scoping review.
Bhangu, Gurjeet; Murray, Alistair; Qayyum, Areeb; Goumeniouk, Natasha; Goodacre, Steve; Hunt, Beverley J; Touhami, Omar; Tester, Jodie; Rees, Megan; Hammerschlag, Gary; Pascoe, Diane; Ronksley, Paul E; King, James A; Choi, Hyun; McDermott, Shaunagh; Le Gal, Gregoire; Skeith, Leslie.
Afiliación
  • Bhangu G; Department of Medicine, University of Calgary, Calgary, AB, Canada.
  • Murray A; Department of Medicine, University of Calgary, Calgary, AB, Canada.
  • Qayyum A; Department of Medicine, University of Calgary, Calgary, AB, Canada.
  • Goumeniouk N; Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada.
  • Goodacre S; School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
  • Hunt BJ; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
  • Touhami O; Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Hôpital Charles-LeMoyne, Sherbrooke University, Quebec, Canada.
  • Tester J; Department of Respiratory Medicine and Sleep Disorders, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Rees M; Department of Respiratory Medicine and Sleep Disorders, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
  • Hammerschlag G; Department of Respiratory Medicine and Sleep Disorders, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Pascoe D; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Ronksley PE; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
  • King JA; Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta SPOR Support Unit Data Platform, Alberta Health Services, Calgary, Alberta, Canada.
  • Choi H; Emergency Department, University Hospital Lewisham, London, United Kingdom.
  • McDermott S; Thoracic Imaging Division, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States.
  • Le Gal G; Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
  • Skeith L; Department of Medicine, University of Calgary, Calgary, AB, Canada; Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: laskeith@ucalgary.ca.
Thromb Res ; 236: 108-116, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38422980
ABSTRACT

BACKGROUND:

The risk of venous thromboembolism (VTE) is increased postpartum and contributes to important morbidity and mortality. While there have been advances in evaluating diagnostic algorithms for suspected VTE during pregnancy, there is limited data for postpartum individuals.

OBJECTIVE:

We conducted a scoping review to describe and evaluate diagnostic strategies used to investigate suspected VTE in postpartum individuals.

METHODS:

A comprehensive search strategy was conducted in Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (January 1, 2000-September 30, 2022) to identify original articles that reported on diagnostic strategies in postpartum individuals with suspected VTE. We extracted demographics, clinical decision rules used, D-dimer and imaging completed, including test performance and VTE outcomes.

RESULTS:

A total of 13 studies conducted across 11 countries with separate postpartum data were included for 759 individuals with suspected PE (n = 634) or DVT (n = 125), including unpublished data (n = 251). Among those with suspected PE, computed tomography pulmonary angiography was conducted more commonly (n = 522) than ventilation-perfusion scans (n = 69), with PE positivity rates that ranged from 4 %-27.6 % and 0-50 % across studies, respectively. Among 131 postpartum individuals with suspected PE who had a D-dimer measured, only 4.6 % (6/131) had a negative D-dimer test. For postpartum individuals with suspected DVT, the most common diagnostic test was compression ultrasonography (positivity rate 12.2 %-18.6 %). There were limited retrospective data evaluating the clinical decision rules.

CONCLUSIONS:

There are heterogeneous approaches globally in the diagnosis of suspected postpartum VTE. Limited high-quality data available underscores the need for more robust evidence to inform clinical practice.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Periodo Posparto / Tromboembolia Venosa Límite: Female / Humans / Pregnancy Idioma: En Revista: Thromb Res Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Periodo Posparto / Tromboembolia Venosa Límite: Female / Humans / Pregnancy Idioma: En Revista: Thromb Res Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos