Diagnosis of pregnancy-associated venous thromboembolism: position paper of the working group in women’s health of the Society of Thrombosis and Haemostasis (GTH)

. Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE). Over the past decade, new diagnostic algorithms have been established, combining clinical probability, laboratory testing and imaging studies for the diagnosis of deep vein thrombosis (DVT) a...

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Main Authors: Linnemann, Birgit (Author) , Bauersachs, Rupert (Author) , Rott, Hannelore (Author) , Halimeh, Susan (Author) , Zotz, Rainer (Author) , Gerhardt, Andrea (Author) , Boddenberg-Pätzold, Barbara (Author) , Toth, Bettina (Author) , Scholz, Ute (Author)
Format: Article (Journal)
Language:English
Published: April 8, 2016
In: Vasa
Year: 2016, Volume: 45, Issue: 2, Pages: 87-101
ISSN:1664-2872
DOI:10.1024/0301-1526/a000503
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1024/0301-1526/a000503
Verlag, lizenzpflichtig, Volltext: https://econtent.hogrefe.com/doi/abs/10.1024/0301-1526/a000503
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Author Notes:Birgit Linnemann, Rupert Bauersachs, Hannelore Rott, Susan Halimeh, Rainer Zotz, Andrea Gerhardt, Barbara Boddenberg-Pätzold, Bettina Toth, and Ute Scholz
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Summary:. Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE). Over the past decade, new diagnostic algorithms have been established, combining clinical probability, laboratory testing and imaging studies for the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in the non-pregnant population. However, there is no such generally accepted algorithm for the diagnosis of pregnancy-associated VTE. Studies establishing clinical prediction rules have excluded pregnant women, and prediction scores currently in use have not been prospectively validated in pregnancy or during the postpartum period. D-dimers physiologically increase throughout pregnancy and peak at delivery, so a negative D-dimer test result, based on the reference values of non-pregnant subjects, becomes unlikely in the second and third trimesters. Imaging studies therefore play a major role in confirming suspected DVT or PE in pregnant women. Major concerns have been raised against radiologic imaging because of foetal radiation exposure, and doubts about the diagnostic value of ultrasound techniques in attempting to exclude isolated iliac vein thrombosis grow stronger as pregnancy progresses. As members of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH), we summarise evidence from the available literature and aim to establish a more uniform strategy for diagnosing pregnancy-associated VTE.
Item Description:Gesehen am 02.06.2020
Physical Description:Online Resource
ISSN:1664-2872
DOI:10.1024/0301-1526/a000503