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KMID : 0358420170600060542
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Korean Journal of Obstetrics and Gynecology
2017 Volume.60 No. 6 p.542 ~ p.548
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The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity
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Kim Se-Jeong
Ahn Hyo-Jeong
Park Jung-Yeon
Kim Byoung-Jae
Hwang Kyu-Ri
Lee Taek-Sang
Jeon Hye-Won
Kim Sun-Min
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Abstract
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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.
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KEYWORD
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Hypertension, pregnancy-induced, Pre-eclampsia, Fibrin?fibrinogen degradation products, d-dimer, Pregnancy
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