The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity.
10.5468/ogs.2017.60.6.542
- Author:
Se Jeong KIM
1
;
Hyo Jeong AHN
;
Jung Yeon PARK
;
Byoung Jae KIM
;
Kyu Ri HWANG
;
Taek Sang LEE
;
Hye Won JEON
;
Sun Min KIM
Author Information
1. Department of Obstetrics and Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. sunmin827@hanmail.net
- Publication Type:Original Article
- Keywords:
Hypertension, pregnancy-induced;
Pre-eclampsia;
Fibrin–fibrinogen degradation products, d-dimer;
Pregnancy
- MeSH:
Autoimmune Diseases;
Biomarkers;
Cohort Studies;
Female;
Gestational Age;
Humans;
Hypertension, Pregnancy-Induced;
Mass Screening;
Pre-Eclampsia;
Pregnancy;
Pregnant Women;
Reference Values;
Retrospective Studies;
Rheumatic Diseases;
Risk Factors;
Thromboembolism;
Venous Thromboembolism
- From:Obstetrics & Gynecology Science
2017;60(6):542-548
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Pregnancy is a major risk factor of thromboembolism, and the patients with preeclampsia (PE) are known to have higher risk of thromboembolic complications than normal pregnant women. D-dimer is a well-established laboratory marker for the screening of venous thromboembolism (VTE), but the concentrations of d-dimer tend to increase physiologically in pregnant women throughout the gestational age. We performed this study to evaluate the clinical significance of d-dimer concentrations in patients with gestational hypertensive disorders (GHD) according to the severity. METHODS: Retrospective cohort study was performed in one institution. Singleton pregnant women with GHD were enrolled, and their antepartum concentrations of d-dimer were measured as a part of routine evaluation for patients suspected with PE. Patients with multiple gestations, rheumatic diseases, autoimmune diseases, or suspected VTE were excluded. A categorization of severity about PE was based on the general criteria. RESULTS: In 73.3% of study population, their d-dimer concentrations exceeded the normal range (>0.55 mg/L). A significantly greater proportion of pregnant women had excessive concentrations of d-dimer in the severe GHD than in the non-severe GHD (89.8% vs. 53.7%; P<0.01). Patients with severe GHD had significantly higher median concentrations of d-dimer than those with non-severe GHD (median [range], 2.00 mg/L [0.11 to 7.49] vs. 0.71 mg/L [0.09 to 5.39]; P<0.01) although their earlier gestational ages of sampling. CONCLUSION: Maternal concentrations of d-dimer were significantly elevated in patients with severe features than those without severe features among those with GHD. Some pregnant women with GHD can have markedly elevated concentrations of d-dimer without any evidence of current VTE.
