Journal of Rare Cardiovascular Diseases

ISSN: 2299-3711 (Print) | e-ISSN: 2300-5505 (Online)

Assessing the role of doppler ultrasound and D-dimer level in predicting asymptomatic DVT during pregnancy

Ali Fawzi Abdalsahib1, Doaa Faris Jabaz2, Abdul Hussein Handooz2
1Department of Internal Medicine, College of Medicine, University of Al-Qadisiya, Iraq
2Department of Surgery, College of Medicine, University of Al-Qadisiya, Iraq
Ali Fawzi Abdalsahib1, Doaa Faris Jabaz2, Abdul Hussein Handooz2
1Department of Internal Medicine, College of Medicine, University of Al-Qadisiya, Iraq
2Department of Surgery, College of Medicine, University of Al-Qadisiya, Iraq
Corresponding Email: ali-fawzi@qu.edu.iq
  • Received 01/08/2024
  • Revised 11/11/2024
  • Accepted 01/01/2025
  • Published 24/02/2025

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Abstract

Background: The d-dimer test is positive even in cases of natural pregnancies. Due to the pregnancy-related hypercoagulable condition, this shows elevated activity of thrombin and enhanced fibrinolysis after formation of fibrin throughout gestation. As a result, this test is unreliable and non-specific for diagnosing venous thrombosis in pregnancy. Objective of the research: the current research was aiming at exploring the role of ultrasound examination in addition to d-dimer investigation in detecting “thrombosis of deep veins” in suspected pregnant women. Patients and methods: A cross observational sectional study was carried out by the researcher in the department of medicine in Adiwaniyah Teaching Hospital, Diwaniyah Province, Iraq between February 2022 and March 2023. Inclusion criteria were as following: pregnant women with clinical suspicion of deep venous thrombosis based on clinical features identified by 2 specialists in internal medicine and who were referred by the Department of Gynecology and Obstetrics. A vacuum tube was used to collect a sample of venous blood from a peripheral vein and was send to central laboratory in the teaching hospital in order to measure d-dimer level. Results: The current study included 90 women of whom 31 (34.4 %) had positive Doppler findings consistent with deep venous thrombosis. There was statistical disparity in the level of d dimer between those with positive DVT Doppler findings and women with negative DVT Doppler findings, 3523.30 ±1773.65ng/ml versus 2553.50 ±1737.96 ng/ml, respectively (p = 0.014). Performance of receiver operating characteristic (ROC) test, showed a cutoff value of > 2200 ng/ml which is a reliable predictor of deep venous thrombosis in pregnant woman with 69 % sensitivity level and 71.8 % specificity level. Conclusion: assessment of serum level of d-dimer is an essential adjunct in the work up for assessment of pregnant women with suspicion of deep venous thrombosis despite the fact that pregnancy is a hypercoagulable state.

key word
pregnancy, d-dimer, deep venous thrombosis

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Classification of Rare Cardiovascular Diseases anticoagulation atrial fibrillation atrial septal defect cardiac tumor cardiomyopathy computed tomography congenital heart disease echocardiography electrocardiogram electrocardiography heart failure implantable cardioverter‑defibrillator magnetic resonance imaging pregnancy pulmonary arterial hypertension pulmonary hypertension rare cardiovascular disease rare disease right heart catheterization right ventricular failure
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