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Related Experiment Videos

Umbilical venous D-dimer concentrations with and without labor

A P Murtha1, K A Boggess, C E Jimmerson

  • 1Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA. murth002@mc.duke.edu

Obstetrics and Gynecology
|August 12, 1998
PubMed
Summary

Labor activates the fetal fibrinolytic system. Umbilical D-dimer concentrations were significantly elevated in newborns delivered after labor compared to those delivered without labor, indicating fetal fibrinolysis activation.

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Area of Science:

  • Obstetrics and Gynecology
  • Fetal Physiology
  • Hemostasis and Thrombosis

Background:

  • The fetal fibrinolytic system's role during labor is not fully understood.
  • Fibrinolysis is crucial for regulating blood clot breakdown.

Purpose of the Study:

  • To investigate whether labor activates the fetal fibrinolytic system.
  • To assess fetal fibrinolysis by measuring D-dimer concentrations in umbilical venous blood.

Main Methods:

  • Umbilical venous blood samples were collected from 59 newborns across four delivery groups: vaginal at term, cesarean after term labor, vaginal preterm, and cesarean without labor.
  • D-dimer concentrations, a marker of fibrinolysis, were measured using enzyme-linked immunosorbent assay.
  • Statistical comparisons were performed using Kruskal-Wallis and Mann Whitney U tests.

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Main Results:

  • No significant D-dimer differences were observed between vaginal and cesarean deliveries following labor (term or preterm).
  • Umbilical venous D-dimer concentrations were significantly higher in newborns delivered after labor (vaginal or cesarean, term or preterm) compared to those delivered by cesarean without labor (427, 773, 326 ng/mL vs. 87 ng/mL, P = .01).

Conclusions:

  • Elevated umbilical plasma D-dimer concentrations in laboring patients suggest activation of fetal fibrinolysis before delivery.
  • These findings indicate that the fetal body responds to labor by activating its clot-dissolving mechanisms.