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
• Publication, Distribution, etc.: Kurume University School of Medicine
• Publication Date: 2019-10-02
• Publication Date (W3CDTF): 2019-10-02
• 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
• Date Granted (W3CDTF): 2019-10-02
• Dissertation Number: 甲総研第533号
• Degree Type: 博士(医学); Doctor of Philosophy in Medical Science
• Conferring No. (Dissertation): 甲総研第533号
• Text Language Code: eng
• Subject Heading: D-dimer; deep vein thrombosis; cutoff level; singleton; twin pregnancies; postpartum hemorrhage
• NDC: 490
• 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 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
• Persistent ID (NDL): info:ndljp/pid/11720632; https://dl.ndl.go.jp/pid/11720632
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 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; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2021-09-06T03:11:00+09:00
• Date Created (W3CDTF): 2020-03-13
• Format (IMT): PDF; application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/10232/00030889
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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