D-dimers as a screening test for venous thromboembolism in pregnancy: is it of any use? (Record no. 75786)

MARC details
000 -LEADER
fixed length control field 04370cam a2200217 4500
001 - CONTROL NUMBER
control field NMDX6629
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 120401t2009 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 01443615
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Damodaram, M.
240 ## - UNIFORM TITLE
Uniform title <a href="Journal of Obstetrics and Gynaecology">Journal of Obstetrics and Gynaecology</a>
245 ## - TITLE STATEMENT
Title D-dimers as a screening test for venous thromboembolism in pregnancy: is it of any use?
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc. 2009
500 ## - GENERAL NOTE
General note NMUH Staff Publications
500 ## - GENERAL NOTE
General note 29
520 ## - SUMMARY, ETC.
Summary, etc. &lt;span style="font-size: 10pt;"&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;In non-pregnant women,&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;D-dimers&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;are used successfully to aid&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;diagnosis&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;of suspected pulmonary embolus (PE), as they have high sensitivity, moderate specificity and high negative predictive value. However, D-dimer levels are physiologically raised in&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;pregnancy&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;and thus overlap the values normally associated with PE. The aim of this retrospective study therefore was to investigate the use of D-dimer levels as a&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;screening&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;test&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;for suspected PE in&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;pregnancy&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;and to determine if a negative D-dimer level could exclude the&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;diagnosis&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;in pregnant women. A total of 37 women suspected of PE had both ventilation perfusion (VQ) scans and D-dimer levels performed. Thirteen were reported as having a low probability of PE following VQ scan, while 24 were thought to have a moderate or high probability of PE. Women who had a low probability of PE following VQ scanning were found to have D-dimer levels ranging from 0.25-2.2 mg/l, while women who had a high probability of PE following scanning had D-dimer levels ranging from 0.31-1.74 mg/l. The sensitivity and specificity of D-dimer as a&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;test&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;for suspected PE in&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;pregnancy&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;was calculated to be 0.73 and 0.15 respectively, while the negative likelihood ratio was 1.8. Current guidelines advocate the use of a negative D-dimer result to exclude the&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;diagnosis&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;of PE in&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;pregnancy&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;. However, this study suggests that D-dimer testing in&amp;nbsp;&lt;/span&gt;&lt;span class="highlight" style="line-height: 17.999801635742188px;"&gt;pregnancy&lt;/span&gt;&lt;span style="line-height: 17.999801635742188px;"&gt;&amp;nbsp;has a high negative likelihood ratio and should not be used. Larger prospective observational studies are required to collaborate the findings from this study.&lt;/span&gt;&lt;/span&gt;
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Kaladindi, M.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Luckit, J.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Yoong, W.
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://www.ncbi.nlm.nih.gov/pubmed/19274539">http://www.ncbi.nlm.nih.gov/pubmed/19274539</a>
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://informahealthcare.com/doi/pdf/10.1080/01443610802649045">http://informahealthcare.com/doi/pdf/10.1080/01443610802649045</a>
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