PB1530 Diagnostic Strategies in Postpartum Individuals with Suspected Venous Thromboembolism: A Scoping Review
Bibliographic record
Abstract
Background: Pregnancy is a hypercoagulable state in which the concentration of coagulation factors increases.Pregnant women with mechanical prosthetic heart valves (MPHV) require therapeutic doses of anticoagulation.In Japan, pregnancy is controlled with unfractionated heparin (UFH) administration while monitoring by activated partial thromboplastin time (APTT).However, management by APTT is difficult.Aims: Pregnant women with MPHV were safely managed with UFH using a protocol based on APTT developed in our obstetrics department.In the present study, we evaluated this protocol with an anti-Xa assay.Methods: Eight patients (5 mitral valve replacements, two aortic valve replacements, and one mitral and aortic valve replacement) who received therapeutic administration of UFH during pregnancy were prospectively enrolled.The protocol called for a therapeutic APTT ratio of 2.0 to 3.0 times the control value (60 to 90 seconds), a UFH dose of less than 30,000 U/day, and a target antithrombin (AT) activity of at least 70%.To avoid fluctuations in heparin levels, continuous intravenous UFH was administered.UFHtreated plasma samples were collected weekly during pregnancy.After APTT measurements, the levels of anti-Xa activity (target range: 0.35-0.70U/mL), factor VIII (FVIII) antigen, and von Willebrand factor (VWF) antigen were measured retrospectively.Results: Plasma antigen levels of FVIII and VWF were progressively increased with the gestational weeks ( p < 0.01).AT activity was 77.6 ± 11.2% (mean ± SD).APTT and anti-Xa activity were generally within therapeutic limits.UFH was increased with gestational week, and generally within 30,000 U/day.Major bleeding occurred in one patient whose APTT and anti-Xa activity were within the therapeutic range.No thrombotic events were observed.Conclusion(s): We evaluated our therapeutic UFH administration protocol using APTT with anti-Xa activity in pregnant women with MPHV.APTT and anti-Xa activity were generally in the therapeutic range, suggesting that this protocol is beneficial for Japanese pregnant women.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.009 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".