Non-invasive imaging in the investigation of deep vein thrombosis in pregnancy

Deep vein thrombosis (DVT) is a serious condition which can be complicated by the development of pulmonary embolism, which has a high mortality and morbidity. There is an increased incidence of deep vein thrombosis in pregnant patients. Effective treatment of DVT by anticoagulation dramatically decreases the risk of pulmonary embolism, but poses risks of its own, particularly in pregnancy, and should not be undertaken without a confirmed diagnosis. Thermal imaging is quick, simple, non-invasive, risk-free, cost-effective and highly sensitive in the initial investigation of suspected DVT; a negative thermogram excludes DVT and avoids the necessity for further investigation. Thermal imaging is, however, non-specific; a positive thermogram has a number of possible causes and is an indication for further assessment by venography or Doppler ultrasound to confirm or exclude DVT. Thermography should be considered the initial investigation of choice in clinically suspected DVT in pregnancy, proceeding to venography or Doppler ultrasound only when thermography is positive.