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Gestation-specific D-dimer reference ranges: a cross-sectional study.
MedLine Citation:
PMID:  24828148     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To establish a gestation-specific reference range for D-dimer in healthy pregnant women with a singleton pregnancy using the Auto-Dimer assay.
DESIGN: Cross-sectional study SETTING: Cork University Maternity Hospital, Ireland.
POPULATION: Healthy pregnant women attending for routine antenatal care.
METHODS: Simultaneous-quantile regression was performed to construct a median, 5th percentile, and 95th percentile, model of normal pregnancy D-dimer concentration versus gestational week, ranging from week 6 to 42. Additionally, pair-wise Mann-Whitney U-tests were performed to compare distributions of D-dimer concentrations for each of the four discrete gestational sampling windows with the distribution of D-dimer concentrations 48 hours postpartum.
MAIN OUTCOME MEASURES: D-dimer concentrations (ng/ml) during normal gestation (approximately week 6 to week 42).
RESULTS: Seven hundred and sixty healthy pregnant women were investigated between gestational age week 5 and 48 hours postpartum. There was a clear steady increase in median D-dimer concentrations over the complete gestational period. Additionally, the 95th centile estimates for all gestational time-points were above the accepted non-pregnancy normal cut-off concentration (224 ng/ml). The results of the Mann-Whitney U-tests suggested that the long-term postnatal return to normal D-dimer concentrations begins in the immediate postpartum period.
CONCLUSIONS: We found that there is a continuous increase in D-dimer concentrations across all gestations. This research is potentially beneficial to future diagnosis of venous thromboembolism (VTE) in pregnancy using the new recommended 95th centile potential cut-offs. Possible further investigation involves an observational study comparing D-dimer concentrations in women with proven DVT with those that don't, generating likelihood ratios.
Authors:
N Murphy; DI Broadhurst; As Khashan; O Gilligan; Lc Kenny; K O'Donoghue
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-15
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  -     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Royal College of Obstetricians and Gynaecologists.
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