Table 1.
Findings of 5 studies of various imaging techniques for symptomatic postpartum OVT
| Reference | Study design | N | Clinical presentation (n) | Imaging modality (n) | Test characteristics |
|---|---|---|---|---|---|
| 10 | Retrospective case series | 7 | Postpartum flank pain (4), fever (3), dyspnea (1), leukocytosis (1) | Ultrasonography with Doppler (7) | Sensitivity: 100% (7/7) |
| CT with contrast (3) | Sensitivity: 100% (3/3) | ||||
| 14 | Prospective cohort study | 26 (9 confirmed cases) | Postpartum fever unresponsive to ≥48 h of antibiotics | Doppler ultrasonography (26) | Sensitivity: 55.6% |
| Specificity: 41.2% | |||||
| CT with contrast (25) | Sensitivity: 77.8% | ||||
| Specificity: 62.5% | |||||
| MRI/MRA method (24) | Sensitivity: 100% | ||||
| Specificity: 100% | |||||
| 12 | Prospective cohort study | 76 (12 confirmed cases) | Postpartum fever for ≥5 d unresponsive to antibiotics | Ultrasonography | Sensitivity: 50% (95% CI, 22-78%) |
| Specificity: 99% (95% CI, 95-100%) | |||||
| NPV: 95% (95% CI, 89-98%) | |||||
| PPV: 85% (95% CI, 42-49) | |||||
| CT with contrast | Sensitivity: 100% (95% CI, 70-100%) | ||||
| Specificity: 99% (95% CI, 95-100%) | |||||
| NPV: 100% (95% CI, 96-100%) | |||||
| PPV: 92% (95% CI, 62-100%) | |||||
| MRI | Sensitivity: 92% (95% CI, 60-100%) | ||||
| Specificity: 100% (95% CI, 96-100%) | |||||
| NPV: 99% (95% CI, 95-100%) | |||||
| PPV: 100% (95% CI, 68-100%) | |||||
| 9 | Retrospective case series | 10 | Postpartum fever/septic shock (9) and abdominal pain (9) | Doppler ultrasonography (10) | Sensitivity: 80% (8/10: 1 false negative confirmed on laparotomy; 1 inconclusive confirmed on CT scan) |
MRA: magnetic resonance angiography; NPV, negative predictive value; PPV, positive predictive value.