Plasma D-Dimer Levels in Normal and Complicated Pregnancies

Abstract

Pregnancy is associated with major physiological changes in the coagulation and fibrinolytic systems. These alterations produce a hypercoagulable state that helps protect against bleeding during placental separation but also complicates interpretation of D-dimer, a degradation product of cross-linked fibrin. To estimate plasma D-dimer levels in women with normal and complicated pregnancies and to evaluate their distribution according to gestational age and selected pregnancy-associated conditions. Thirty-seven pregnant women were included. Blood was collected into sodium citrate tubes, citrated plasma was obtained by centrifugation at 1500 × g for 15 minutes, and D-dimer was measured using a manual semi-quantitative latex agglutination assay (Helena Biosciences Europe, UK). Data were analyzed using SPSS version 16.0. The mean age was 31.62 ± 5.28 years. The overall mean D-dimer concentration was 1617.81 ± 1586.45 ng/mL (range, 121–7200). Mean D-dimer concentrations were 672.63 ± 532.84 ng/mL in the first trimester, 2660.27 ± 2038.41 ng/mL in the second trimester, and 1400.83 ± 1263.02 ng/mL in the third trimester. D-dimer was >500 ng/mL in 27 women (73%). The association between gestational trimester and categorized D-dimer level was not statistically significant (P=0.139). Elevated D-dimer levels were common in this study population and varied across gestational trimesters. Interpretation of D-dimer during pregnancy should consider physiological pregnancy-related changes, gestational age, and associated clinical conditions.