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D-D dimers: a poor correlate of PPIH and subsequent outcomes
G Royle1, C L Barry, H Blacklock
1Haematology Department, Middlemore Hospital, Auckland, New Zealand.
Objectives:
To ascertain the normal range of D-D dimer levels in pregnancy in our population, and whether dimer levels are of value as a correlate of proteinuric pregnancy-induced hypertension (PPIH) or a predictor of adverse outcome.
Methods:
Dimer levels were measured in 44 women diagnosed with PPIH after 32 weeks' gestation and 55 controls recruited before 24 weeks' gestation.
Results:
Mean dimer levels in the second and third trimester of normal pregnancy were 45 ng/ml (+/- 1 S.D., 15-134) and 85 ng/ml (+/- 1 S.D., 40-180), respectively (P < 0.001). Mean dimer level in PPIH was 148 ng/ml (+/- 1 S.D., 76-292), differing significantly from normal pregnancy by ELISA but not by latex particle assay. No correlation was found between dimer levels and adverse outcome, nor between dimer levels and any one particular adverse outcome.
Conclusion:
These results suggest that dimer levels are not a useful correlate of PPIH, nor do they have a useful predictive value for adverse outcome in PPIH.