Diagnosis of deep venous thrombosis in obstetrics and gynecology by impedance phlebography.

The accurate diagnosis of deep venous thrombosis is fundamental in reducing the morbidity and mortality from thromboembolism in obstetrics and gynecology. This is the first report of the use of a noninvasive diagnostic technique, occlusive cuff impedance phlebography (IPG), on an obstetric and gynecologic service. One hundred sixteen patients were examined by IPG with an overall diagnostic accuracy of 95.6% (sensitivity, 87.5%; specificity, 93.8%). Ninety-one patients had symptoms suggestive of deep venous thrombosis, but this diagnosis was confirmed in only 26.3%. The use of IPG to screen high-risk patients prospectively and evaluate patients with pulmonary emboli is discussed. IPG is ideally suited as a diagnostic method in obstetrics and gynecology because it is accurate, noninvasive, and nonradiologic, and it may be performed at the patient's bedside.