D-dimer negative deep vein thrombosis in puerperium

Venous thrombo-embolism (VTE) is a major cause of morbidity and mortality during pregnancy. Most of the evidence being used in the management of this condition in pregnancy is extrapolated from the general population. One such intervention is the use of the D-dimer test for the diagnosis of thromboembolism in pregnancy. Although this test has been found to be useful in low-risk non-pregnant patients, its negative predictive value is limited in high-risk patients in the general population to be used as a reliable diagnostic tool. Considering pregnancy as a high-risk state for VTE, we have evaluated the role of D-dimer in diagnosing VTE in pregnancy and proposed a diagnostic algorithm for the management of VTE based on the current evidence available.