Prediction of deep venous thrombosis in lower extremities of pregnant women before and after delivery by color Doppler ultrasound combined with snowstorm sign and coagulationstatus
Zhang Wenjuan, Wang Fei, Xing Xiaoshuai, Sun Botong, Zhai Yinwei, Liu Chunying
Chinese People′s Armed Police Force Characteristic Medical Center, Tianjin 300162, China
Abstract：Objective To investigate the predictive performance of color Doppler ultrasonography combined with blood coagulation on the occurrence of postpartum deep venous thrombosis (VTE). Methods In this retrospective study, the clinical data of 246 parturients delivered between January 2014 and October 2018 were analyzed. According to the snowstorm sign (presence or absence) and coagulation status at 1 week before delivery and at 1 week postpartum, 73 cases were divided into single prediction group (only one abnormality in either color Doppler ultrasound or coagulation status), 68 cases into ultrasound prediction group (abnormalities in color Doppler ultrasound were identified both before delivery and postpartum), 109 cases into combined prediction group (ultrasound abnormalities both before delivery and postpartum plus two abnormalities in coagulation status, and including 68 cases into ultrasound prediction group). The VTE occurrence was compared among the three groups, and the sensitivity and specificity of the prediction were also compared. In addition, there were 64 pregnant women with normal results. Results There was no significant difference in general characteristics among the three groups. The levels of FIB, D-dimer and coagulation factor activity in the combined prediction group were significantly higher than those in the ultrasound prediction group. There were 44 cases (17.9%) of VTE in 246 patients, including 38 cases of VTE in the combined prediction group, 21 cases of VTE in the ultrasound prediction group (30.9%), 3 cases of thrombosis in the single prediction group (4.1%) and 3 cases of normal pregnant women (4.7%). There were significant differences in the cumulative incidence of VTE among the three groups by Kaplan-Meier method (χ2=22.836, P=0.000). The sensitivity (86.4%) and specificity (35.1%) of the combined prediction group were the highest. Conclusion Ultrasound snowstorm during perinatal period in combination with coagulation status has high sensitivity and specificity in assisting the diagnosis of prethrombotic state of pregnant women and predicting deep venous thrombosis of lower limbs.
张文娟, 王飞, 苏玉美, 邢小帅, 孙博通, 翟银伟, 刘春影. 孕妇分娩前后彩超暴风雪征联合凝血状态对产后下肢深静脉血栓发生的预测研究[J]. 中国生育健康杂志, 2019, 30(5): 415-418.
Zhang Wenjuan, Wang Fei, Xing Xiaoshuai, Sun Botong, Zhai Yinwei, Liu Chunying. Prediction of deep venous thrombosis in lower extremities of pregnant women before and after delivery by color Doppler ultrasound combined with snowstorm sign and coagulationstatus. Chinese Journal of Reproductive Health, 2019, 30(5): 415-418.
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