Evaluation of D-dimer during pregnancy.

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Diagnostic Medicine

Background:

• Deep vein thrombosis (DVT) is a significant concern during pregnancy.
• Accurate screening methods for DVT in pregnant populations are crucial.

Purpose of the Study:

• To investigate the dynamic changes in D-dimer levels throughout pregnancy.
• To evaluate the efficacy of D-dimer as a screening tool for DVT in pregnant women.

Main Methods:

• A cohort of 1,131 pregnant women was studied.
• D-dimer levels were measured using latex immunoassay at 6-14 and 30-36 weeks of gestation.
• Lower extremity veins were assessed via ultrasound at 30-36 weeks of gestation.

Main Results:

• Mean D-dimer levels were significantly elevated in both the first (1.1 +/- 1.0 microg/mL) and third trimesters (2.2 +/- 1.1 microg/mL) compared to non-pregnant adults.
• D-dimer levels increased significantly as pregnancy progressed.
• In the third trimester, twin pregnancies showed higher D-dimer levels (3.7 +/- 2.5 microg/mL) than singleton pregnancies (2.2 +/- 1.6 microg/mL).
• Ultrasonographically positive DVT cases had a mean D-dimer of 2.6 +/- 2.0 microg/mL in the third trimester.
• A D-dimer threshold of 3.2 microg/mL yielded a positive predictive value of 7.4% and a negative predictive value of 95.5% for DVT.

Conclusions:

• D-dimer levels undergo significant changes during pregnancy.
• A D-dimer level exceeding 3.2 microg/mL in pregnant women is associated with a higher likelihood of DVT.
• Close monitoring of pregnant women with D-dimer levels above 3.2 microg/mL is advised for the prevention of pulmonary thromboembolism.