帝王切開術前の深部静脈血栓症に対するD-dimerのカットオフ値およびD-dimerと帝王切開術中出血量の関与についての検討

• Material Type: 博士論文
• Title: 帝王切開術前の深部静脈血栓症に対するD-dimerのカットオフ値およびD-dimerと帝王切開術中出血量の関与についての検討
• Author/Editor: 折田, 有史
• Author Heading: 折田, 有史 オリタ, ユウジ
• Publication, Distribution, etc.: Kurume University School of Medicine
• Alternative Title: 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
• Degree grantor/type: 鹿児島大学
• Date Granted: 2019-10-02
• Dissertation Number: 甲総研第533号
• Degree Type: 博士(医学); Doctor of Philosophy in Medical Science
• Text Language Code: eng
• Subject Heading: D-dimer; deep vein thrombosis; cutoff level; singleton; twin pregnancies; postpartum hemorrhage
• Target Audience: 一般
• Note (General): 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 amounts during 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 KOBAYASHI 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 The Kurume Medical Journal (2019) 66(2) 107-114 https://doi.org/10.2739/kurumemedj.MS662003
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 鹿児島大学 : 鹿児島大学リポジトリ

Table of Contents

Result_Orita_Yuji_isk_533 other

Comments_Orita_Yuji_isk_533 other

Diss_折田_有史_ISK533_2019 fulltext

Abstract_折田_有史_4512800161_2019 abstract