scholarly journals Evaluation of the Diagnostic Accuracy of Serum D-Dimer Levels in Pregnant Women with Adnexal Torsion

Diagnostics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Hasan Topçu ◽  
Can İskender ◽  
Ufuk Ceran ◽  
Oktay Kaymak ◽  
Hakan Timur ◽  
...  
2020 ◽  
Vol 37 (7) ◽  
pp. 423-428
Author(s):  
Steve Goodacre ◽  
Catherine Nelson-Piercy ◽  
Beverley J Hunt ◽  
Gordon Fuller

ObjectiveRecent studies suggest that combinations of clinical probability assessment (the YEARS algorithm or Geneva score) and D-dimer can safely rule out suspected pulmonary embolism (PE) in pregnant women. We performed a secondary analysis of the DiPEP (Diagnosis of Pulmonary Embolism in Pregnancy) study data to determine the diagnostic accuracy of these strategies.MethodsThe DiPEP study prospectively recruited and collected data and blood samples from pregnant/postpartum women with suspected PE across 11 hospitals and retrospectively collected data from pregnant/postpartum women with diagnosed PE across all UK hospitals (15 February 2015 to 31 August 2016). We selected prospectively recruited pregnant women who had definitive diagnostic imaging for this analysis. We used clinical data and D-dimer results to determine whether the rule out strategies would recommend further investigation. Two independent adjudicators used data from imaging reports, treatments and adverse events up to 30 days to determine the reference standard.ResultsPEs were diagnosed in 12/219 (5.5%) women. The YEARS/D-dimer strategy would have ruled out PE in 96/219 (43.8%) but this would have included 5 of the 12 with PEs. Sensitivity for PE was 58.3% (95% CI 28.6% to 83.5%) and specificity 44.0% (37.1% to 51.0%). The Geneva/D-dimer strategy would have ruled out PE in 46/219 (21.0%) but this would have included three of the 12 with PE. Sensitivity was 75.0% (95% CI 42.8% to 93.3%) and specificity 20.8% (95% CI 15.6% to 27.1%). Administration of anticoagulants prior to blood sampling may have reduced D-dimer sensitivity for small PE.ConclusionStrategies using clinical probability and D-dimer have limited diagnostic accuracy and do not accurately rule out all PE in pregnancy. It is uncertain whether PE missed by these strategies lead to clinically important consequences.


Author(s):  
Matteo Nicola Dario Di Minno ◽  
Ilenia Calcaterra ◽  
Antimo Papa ◽  
Roberta Lupoli ◽  
Alessandro Di Minno ◽  
...  

2016 ◽  
Vol 49 (9) ◽  
pp. 688-691
Author(s):  
Yu Wang ◽  
Jie Gao ◽  
Juan Du
Keyword(s):  

Author(s):  
Rahajuningsih Dharma ◽  
Mercy T. Panjaitan ◽  
Kanadi Sumapradja ◽  
Rianto Setiabudy

Abstract Objective: To obtain the profile of D-dimer in uncomplicated pregnancy. Methods: A cross sectional study was done on 90 uncomplicated pregnant women consisted of 30 women in each trimester and 30 healthy, nonpregnant women as control group from July to August 2012. D-dimer level was measured by particle enhanced immunoturbidimetry method using Innovance D-dimer and Sysmex CA 1500 in the Department of Clinical Pathology, Dr. Cipto Mangunkusumo Hospital, Jakarta. Results: All women in the control group showed normal D-dimer level (<0.,5 mg/L FEU). The median and range of D-dimer level in the 1st trimester, 2nd trimester, and 3rd trimester were 0.42 mg/L FEU and 0.1-1.07 mg/L FEU, 0.97 mg/L FEU and  0.6-3.34 mg/L FEU, and 1.56 mg/L FEU and  0.69-3.75 mg/L FEU, respectively.  Increased D-dimer level was found in 27% of pregnant women in 1st trimester, 87% in 2nd trimester, and 100% in 3rd trimester. Conclusion: Increased D-dimer level was found in  27% of pregnant women in 1st trimester, 87% in 2nd trimester, and  100% in 3rd trimester. The range of D-dimer level in the 1st trimester was 0.1-1.07 mg/L FEU, in the 2nd trimester was 0.6-3.34 mg/L FEU, and in the 3rd trimester was 0.69-3.75 mg/L FEU. Keywords: D-dimer, trimester, uncomplicated pregnancy   Abstrak Tujuan : Untuk mendapatkan profil  D-dimer pada kehamilan tanpa komplikasi. Metode : Penelitian potong lintang dilakukan pada 90 perempuan hamil tanpa komplikasi yang terdiri atas 30 perempuan pada tiap trimester dan 30 perempuan sehat yang tidak hamil, sebagai kelompok kontrol dari bulan Juli sampai Agustus 2012. Kadar D-dimer diukur dengan cara particle enhanced immunoturbidimetry  menggunakan reagen InnovanceÒ D-dimer dan koagulometer SysmexÒ CA 1500 di  Deparemen Patologi Klinik, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Hasil: Seluruh perempuan dalam kelompok kontrol mempunyai kadar D-dimer dalam batas normal (<0.,5 mg/L FEU). Median (rentang) kadar D-dimer  pada trimester pertama, kedua, dan ketiga berturut-turut  0.42 mg/L FEU  (0.1-1.07 mg/L FEU), 0.97 mg/L FEU (0.6-3.34 mg/L FEU), dan 1.56 mg/L FEU   (0.69-3.75 mg/L FEU).  Peningkatan kadar D-dimer ditemukan pada 27% perempuan hamil trimester pertama, 87%  trimester kedua, dan pada 100%  trimester ketiga.   Kesimpulan: Peningkatan kadar  D-dimer ditemukan pada  27% perempuan hamil trimester pertama,  87% trimester kedua dan   100% pada trimester ketiga.  Rentang kadar D-dimer level pada trimester pertama adalah 0.1-1.07 mg/L FEU, pada trimester kedua  0.6-3.34 mg/L FEU, dan pada trimester ketiga  0.69-3.75 mg/L FEU. Kata kunci: D-dimer, kehamilan tanpa komplikasi, trimester


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018132 ◽  
Author(s):  
Carmen Phang Romero Casas ◽  
Marrissa Martyn-St James ◽  
Jean Hamilton ◽  
Daniel S Marinho ◽  
Rodolfo Castro ◽  
...  

ObjectivesTo undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women.MethodsFive electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women. Methodological quality was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). A bivariate meta-analysis was undertaken to generate pooled estimates of diagnostic parameters. Results were presented using a coupled forest plot of sensitivity and specificity and a scatter plot.ResultsThe methodological quality of the five included studies with regards to risk of bias and applicability concern judgements was either low or unclear. One study was judged as high risk of bias for patient selection due to exclusion of pregnant women with a previous history of syphilis, and one study was judged at high risk of bias for study flow and timing as not all patients were included in the analysis. Five studies contributed to the meta-analysis, providing a pooled sensitivity and specificity for ICS of 0.85 (95% CrI: 0.73 to 0.92) and 0.98 (95% CrI: 0.95 to 0.99), respectively.ConclusionsThis review and meta-analysis observed that rapid ICS POC tests have a high sensitivity and specificity when performed in pregnant women at antenatal clinics. However, the methodological quality of the existing evidence base should be taken into consideration when interpreting these results.PROSPERO registration numberCRD42016036335.


2018 ◽  
Vol 24 ◽  
pp. 2031-2037 ◽  
Author(s):  
Zhiyun Jiang ◽  
Junfen Ma ◽  
Qian Wang ◽  
Fan Wu ◽  
Jiedan Ping ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Zhongliang Duan ◽  
Cui Li ◽  
Wing Ting Leung ◽  
Jiangnan Wu ◽  
Mingyan Wang ◽  
...  

The precise pathophysiological mechanisms of preeclampsia (PE) and preventative strategies remain unknown. Laboratory markers which can help in identifying PE patients from pregnant women and assessing the severity of PE during pregnancy are worthy to be explored. In this study, a retrospective case-control study was designed to assess whether the serum levels of albumin (ALB), total protein (TP), prealbumin (PA), alkaline phosphatase (ALP), lactic dehydrogenase (LDH), D-dimer, fibrinogen (Fbg), platelet (PLT) count, mean platelet volume (MPV), and platelet distribution width (PDW) can help in assessing PE and evaluate its severity. 256 pregnant women were enrolled and classified into 3 groups: mild preeclampsia (mPE, n=85), severe preeclampsia (sPE, n=78), and healthy normotensive controls (control, n=93). Our result showed that the serum levels of ALP, LDH, and D-dimer were significantly higher in mild or severe PE patients compared with the healthy controls (66 (52.5-76.5) vs. 168 (141.5-201.25) vs. 182.5 (120-191.5), 152 (139.75-166.25) vs. 183.5 (163.25-307) vs. 282 (215.25-306), 1.05 (0.65-1.57) vs. 3.05 (2.25-4.08) vs. 5.65 (2.29-7.71)), while ALB, TP, and PA are lower (38 (37-42) vs. 31.5 (25.5-34.5) vs. 28.5 (24-33), 65 (63-68.25) vs. 56.5 (52-61) vs. 51.5 (49-58), 219.14±68.25 vs. 167.88±52.21 vs. 143.22±50.46). On the other hand, compared with the mPE group, the sPE group showed significantly lower PLT count but higher level of LDH, D-dimer, and Fbg. No significant differences in MPV or PDW were found between any of the two groups. In conclusion, the above markers except for the MPV and PDW may be correlated with PE severity in this patient cohort, indicating possible values of these potential biomarkers in auxiliary diagnosis and severity assessment of PE.


1993 ◽  
Vol 86 (9) ◽  
pp. 1017-1021 ◽  
Author(s):  
KENNETH F. TROFATTER ◽  
MICHELE O. TROFATTER ◽  
MICHAEL R. CAUDLE ◽  
DAVID Q. OFFUTT
Keyword(s):  

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