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Related Experiment Videos

D-dimer levels during delivery and the postpartum.

M Epiney1, F Boehlen, M Boulvain

  • 1Department of Obstetrics and Gynecology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.

Journal of Thrombosis and Haemostasis : JTH
|January 27, 2005
PubMed
Summary

D-dimer (DD) levels remain elevated for 3 days postpartum, hindering venous thromboembolism (VTE) exclusion. DD testing becomes reliable again around 4 weeks after delivery, aiding VTE diagnosis in postpartum women.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Diagnostic Medicine

Background:

  • D-dimer (DD) is valuable for excluding venous thromboembolism (VTE) in outpatients.
  • Pregnancy-related physiological DD increases limit its utility for VTE exclusion.
  • Limited data exists on postpartum DD levels.

Purpose of the Study:

  • To establish sequential reference intervals for postpartum DD levels.
  • To determine when DD levels normalize for effective VTE exclusion.
  • To assess DD utility in postpartum VTE diagnosis.

Main Methods:

  • 150 women with uncomplicated pregnancies were studied.
  • DD levels measured immediately postpartum and at days 1, 3, 10, 30, and 45.
  • Vaginal delivery (n=100) and cesarean section (n=50) groups analyzed.

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Main Results:

  • Marked DD elevation observed immediately postpartum, especially after instrumental delivery.
  • DD levels exceeded 500 ng/mL at delivery, day 1, and day 3.
  • A sharp DD decrease occurred between days 1 and 3, with normalization by 4 weeks in most women.
  • Bleeding, breastfeeding, and heparin prophylaxis did not significantly alter DD levels.

Conclusions:

  • New reference intervals for postpartum DD levels were established using the Vidas DD assay.
  • DD measurement using a 500 ng/mL cut-off is useful for VTE exclusion approximately 4 weeks postpartum.
  • This study provides crucial data for managing VTE risk in the postpartum period.