Plasma fibrin D-dimer in pregnancies complicated by partial placental abruption

To evaluate the value of the plasma fibrin D-dimer test, a sensitive indicator of coagulation abnormalities, as a method of affirmation of partial placental abruption.

Fibrin D-dimer studies were obtained on 25 healthy, normotensive gravidas with late second and third trimester uterine bleeding and a clinical diagnosis of partial placental abruption. The test was repeated 24 hours later if bleeding persisted. The results were compared with D-dimer tests done on 30 healthy, term gravidas. Postpartum, all placentas were evaluated for evidence of abruption, and those suspected of abruption were sent for pathologic evaluation.

Three of 34 D-dimer tests, performed on 25 women who had 28 bleeding episodes, were mildly elevated. At delivery, 12 of the 25 placentas showed evidence of abruption, and six had pathologic findings suggesting abruption. One of the 16 D-dimer tests done on these 12 women was mildly elevated, and 2 of the 18 tests done on the other 13 women, whose placentas appeared normal, were mildly elevated. All 30 D-dimer studies in the control group were normal. The difference between the study group and the controls' results was not significant (P = 0.3).

We did not find the fibrin D-dimer test to be of value in substantiating the diagnosis of partial placental abruption.