The risk of venous thromboembolism (VTE) is increased postpartum and contributes to important morbidity and mortality. While there have been advances in evaluating diagnostic algorithms for suspected VTE during pregnancy, there is limited data for postpartum individuals. We conducted a scoping review to describe and evaluate diagnostic strategies used to investigate suspected VTE in postpartum individuals. A comprehensive search strategy was conducted in Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (January 1, 2000-September 30, 2022) to identify original articles that reported on diagnostic strategies in postpartum individuals with suspected VTE. We extracted demographics, clinical decision rules used, D-dimer and imaging completed, including test performance and VTE outcomes. A total of 13 studies conducted across 11 countries with separate postpartum data were included for 759 individuals with suspected PE ( = 634) or DVT ( = 125), including unpublished data ( = 251). Among those with suspected PE, computed tomography pulmonary angiography was conducted more commonly ( = 522) than ventilation-perfusion scans ( = 69), with PE positivity rates that ranged from 4 %–27.6 % and 0–50 % across studies, respectively. Among 131 postpartum individuals with suspected PE who had a D-dimer measured, only 4.6 % (6/131) had a negative D-dimer test. For postpartum individuals with suspected DVT, the most common diagnostic test was compression ultrasonography (positivity rate 12.2 %–18.6 %). There were limited retrospective data evaluating the clinical decision rules. There are heterogeneous approaches globally in the diagnosis of suspected postpartum VTE. Limited high-quality data available underscores the need for more robust evidence to inform clinical practice.

中文翻译：

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疑似静脉血栓栓塞产后个体的诊断策略：范围审查

产后静脉血栓栓塞 (VTE) 的风险增加，并导致严重的发病率和死亡率。尽管在评估妊娠期间疑似 VTE 的诊断算法方面取得了进展，但产后个体的数据有限。我们进行了范围界定审查，以描述和评估用于调查产后个体疑似 VTE 的诊断策略。在 Ovid MEDLINE、Embase 和 Cochrane 对照试验中央注册库（2000 年 1 月 1 日至 2022 年 9 月 30 日）中进行了全面的检索策略，以识别报告疑似 VTE 产后个体诊断策略的原始文章。我们提取了人口统计数据、使用的临床决策规则、D-二聚体和完成的成像，包括测试表现和 VTE 结果。共有 13 项研究在 11 个国家进行，包含 759 名疑似 PE (= 634) 或 DVT (= 125) 的个体，其中包括未发表的数据 (= 251)。在疑似肺栓塞的患者中，计算机断层扫描肺血管造影 (= 522) 比通气灌注扫描 (= 69) 更常见，各项研究中肺栓塞阳性率分别为 4%–2​​7.6% 和 0–50%。在 131 名疑似先兆子痫并进行 D-二聚体检测的产后个体中，只有 4.6% (6/131) 的 D-二聚体检测呈阴性。对于疑似 DVT 的产后个体，最常见的诊断测试是压迫超声检查（阳性率为 12.2%–18.6%）。评估临床决策规则的回顾性数据有限。全球范围内诊断疑似产后 VTE 的方法各不相同。可用的高质量数据有限，强调需要更强有力的证据来指导临床实践。