67: Improved diagnosis of preeclampsia with severe features and end organ injury using complement activation measurement in urine and plasma

Abstract

(RCOG). High-risk patients were defined as a Padua score of 4, Caprini 2, and RCOG 2. Three different cutoffs were analyzed for the Caprini RAM. The primary outcome was VTE occurring during delivery or up to 1 year postpartum. We calculated the proportion of women who would have been high risk, determined the number of VTE cases within high and low risk category, as well as calculated the number needed to treat (NNT) for each RAM. We performed sensitivity analyses using different cutoffs for the RAM scores, upper limit of VTE risk, and different efficacy of anticoagulation to prevent VTE. RESULTS: A total of 6158 women were included. The overall rate of VTE was 0.05%, 95% CI (0.01-0.15). The proportion of women categorized at high risk for VTE were 62% for RCOG, 0.8% for Padua, and 94% for Caprini (Table 1). There were no differences in the rates between the high and low risk for any of the RAMs (Table 1). The observed NNT assuming 100% efficacy of thromboprophylaxis was 3838 for RCOG, not able to calculate for Padua and 1927 for Caprini (Table 2). For the best-case scenario (using upper limit of VTE rate and 100% efficacy) the NNT was 1000 for RCOG, 14 for Padua and 1000 for Caprini (Table 2). NNTs for additional scenarios are provided in Table 2. CONCLUSION: The rates of VTE in pregnancy are very low and the available RAMs do not identify most of them. The RCOG and Caprini RAMs would categorize a large proportion of women as high risk and are associated with high NNTs. The Padua RAM appears to have the lowest NNT but failed to identify all VTEs in the study.