並列タイトル等The optimal cutoff level of D-dimer during pregnancy to exclude deep vein thrombosis, and the association between D-dimer and postpartum hemorrhage in Cesarean section patients
学位博士(医学)
Doctor of Philosophy in Medical Science
一般注記博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨
Objective: The main purpose was to clarify the optimal D-dimer cutoff level during pregnancy to exclude deep vein thrombosis (DVT) prior to Cesarean section. The secondary purpose was to determine whether D-dimer can predict severe postpartum hemorrhage (PPH) in Cesarean section patients.Methods: Two hundred and seventy eight elective Cesarean section cases were enrolled. Clinical factors and blood parameters at 34-37 weeks of gestation were analyzed. To detect DVT, lower extremities veins were examined using color Doppler ultrasonography in cases with D-dimer level ＞＿ 1.5 μg/mL. In addition, postpartum blood loss amountsduring Cesarean section were recorded.Results: Five DVT cases occurred in 250 singleton pregnancies, and 2 DVT cases occurred in 28 twin pregnancies. The overall incidence of DVT was 2.5%. The D-dimer level was higher in DVT cases than in non-DVT cases (3.84±1.97 vs. 2.31±1.48 μg/mL, P<0.01). The optimal D-dimer cutoff level was 2.6 μg/mL with a negative predictive value of 99.5%, and sensitivity of 85.7%. PPH during Cesarean section was positively correlated with D-dimer level in all pregnancies. However, this relationship disappeared after excluding twin pregnancies.Conclusion: A D-dimer level < 2.6 μg/mL at 34-37 weeks of gestation has the potential to exclude DVT. D-dimer can be an independent predictor for severe PPH for all Cesarean section cases, including twin pregnancies.YUJI ORITA, TOMONORI HAMADA, SHINICHI TOGAMI, TSUTOMU DOUCHI, HIROAKI KOBAYASHIThe Optimal Cutoff Level of D-Dimer during Pregnancy to Exclude Deep Vein Thrombosis, and the Association between D-Dimer and Postpartum Hemorrhage in Cesarean Section PatientsThe Kurume Medical Journal (2019) 66(2) 107-114https://doi.org/10.2739/kurumemedj.MS662003
コレクション（個別）国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
受理日（W3CDTF）2021-09-06T03:11:00+09:00
連携機関・データベース国立国会図書館 : 国立国会図書館デジタルコレクション