D- Dimer a safe diagnostic test to rule out VTE during pregnancy, finds study

Researchers identified 665 references through a systematic database and additional search strategies, out of which 45 studies were retrieved in full, of which four were included, after applying exclusion criteria. Three studies were prospective, and one had a retrospective design. The 3-month thromboembolic rate in pregnant women left untreated after a negative D-dimer was 1/312 (0.32%; 95% CI, 0.06–1.83). The pooled estimate values were 99.5% for sensitivity (95% CI, 95.0–100.0; I², 0%) and 100% for negative predictive value (95% CI, 99.19–100.0; I², 0%). The prevalence of VTE and the yield of D-dimer were 7.4% (95% CI, 3.8–12; I², 83%) and 34.2% (95% CI, 15.9–55.23; I², 89%) respectively.

The researchers concluded that "Our results suggest that D-dimer allows to safely rule out VTE in pregnant women with suspected VTE and a disease prevalence consistent with a low/intermediate or unlikely pretest probability." The D-dimer can be used to safely rule out acute VTE in pregnant women without a high pre-test probability for VTE.

For further information: https://doi.org/10.1111/jth.15432.