scholarly journals D-Dimer Concentrations in Normal Pregnancy: New Diagnostic Thresholds Are Needed

2005 ◽  
Vol 51 (5) ◽  
pp. 825-829 ◽  
Author(s):  
Jeffrey A Kline ◽  
Ginger W Williams ◽  
Jackeline Hernandez-Nino
Keyword(s):  
Fetal Loss ◽  
Pregnant Patient ◽  
Normal Pregnancy ◽  
Progressive Increase ◽  
Third Trimester ◽  
The Third ◽  
Diagnostic Thresholds ◽  
Turbidimetric Assay ◽  
D Dimer ◽  
Rule Out

Abstract Background: Pregnancy is known to increase the D-dimer concentration above the conventional normal threshold of 0.50 mg/L, leading to an increased false-positive D-dimer test when venous thromboembolism (VTE) is clinically suspected in a pregnant patient. Our aim was to determine the effect of normal pregnancy on the D-dimer concentration. Methods: Healthy women who were seeking to become pregnant and had no preexisting condition known to increase the D-dimer concentration were identified. Quantitative D-dimer measurements (MDA turbidimetric assay) and fibrinogen assays were performed before conception, at each trimester, and at 4 weeks postpartum. Patients were excluded for fetal loss or preeclampsia. Results: A total of 50 women were enrolled in the study, and blood samples were obtained at preconception and all trimesters from 23 women. The mean (SD) preconception D-dimer concentration was 0.43 (0.49) mg/L, and 79% of women had a D-dimer concentration <0.50 mg/L. D-Dimer increased with each trimester such that only 22% of women in the second trimester and none (of 23) in the third trimester (95% confidence interval, 0–14%) had a D-dimer concentration <0.50 mg/L. We found no correlation between either the D-dimer and fibrinogen concentrations or between the increases in D-dimer and fibrinogen with pregnancy. Conclusions: Normal pregnancy causes a progressive increase in circulating D-dimer. The D-dimer test has no use in ruling out VTE in the third trimester if a cutoff of 0.50 mg/L is used. A large management study is needed to establish new thresholds for the D-dimer to rule out VTE in each trimester.

‘In vitro’ Cytokine Secretion by Peripheral Blood and Decidual Lymphocytes during the Third Trimester of Normal Pregnancy

2003 ◽  
Vol 55 (2) ◽  
pp. 68-72 ◽  
Author(s):  
J.R. Wilczynski ◽  
H. Tchórzewski ◽  
E. Głowacka ◽  
M. Banasik ◽  
M. Szpakowski ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Normal Pregnancy ◽  
Cytokine Secretion ◽  
Third Trimester ◽  
The Third

Alterations of serum resistin in normal pregnancy and pre-eclampsia

2004 ◽  
Vol 108 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Danqing CHEN ◽  
Minyue DONG ◽  
Qin FANG ◽  
Jing HE ◽  
Zhengping WANG ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
Resistin Level ◽  
Blood Samples ◽  
The Third ◽  
Maternal Adaptation ◽  
Serum Resistin Level ◽  
One Way Anova ◽  
Insight Into

Resistin is expressed in human placenta and has been postulated to play a role in regulating energy metabolism in pregnancy. However, changes in serum resistin levels in normal pregnancy and in the setting of pre-eclampsia are far from understood. The purpose of the present study was to clarify the alterations in serum resistin level in normal pregnancy and pre-eclampsia. Blood samples were taken from 28 healthy non-pregnant women, 27 women in the first, 26 in the second and 26 in the third trimesters of normal pregnancy and 25 women with pre-eclampsia. Serum resistin concentrations were determined by using an ELISA, and mean serum resistin levels were compared with one-way ANOVA. Serum resistin levels were not significantly different among non-pregnant women and women in the first and second trimesters of pregnancy (P>0.05 for all). Serum resistin was significantly elevated in the third trimester of normal pregnancy compared with non-pregnant women (P<0.01) and women in the first (P<0.001) and second (P<0.001) trimesters of pregnancy. Serum resistin level was significantly lower in women with pre-eclampsia than women in the third trimester of normal pregnancy (P<0.001), but was comparable with those of non-pregnant women and women in the first and second trimesters of pregnancy (P>0.05 for all). In conclusion, we found an increase in serum resistin in the third trimester of normal pregnancy, but this increase was not present in pre-eclampsia. We postulate that these associations may offer insight into the mechanisms of maternal adaptation to pregnancy and the pathogenesis of pre-eclampsia.

Stroke Volume Recruitability during the Third Trimester of Pregnancy

2017 ◽  
Vol 35 (08) ◽  
pp. 737-740 ◽  
Author(s):  
Sandra Herrera ◽  
Maggie Kuhlmann-Capek ◽  
Sarah Rogan ◽  
Antonio Saad ◽  
George Saade ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Pregnant Women ◽  
Vena Cava ◽  
Normal Pregnancy ◽  
Gravid Uterus ◽  
Third Trimester ◽  
Fluid Bolus ◽  
The Third ◽  
Hemodynamic Variables ◽  
Flat Portion

Objective It is unknown whether the heart operates in the ascending or flat portion of the Starling curve during normal pregnancy. Pregnant women do not respond to the passive leg-raising maneuver secondary to mechanical obstruction of the inferior vena cava by the gravid uterus. Our objective was to evaluate if administration of a fluid bolus increases baseline stroke volume (SV) among healthy pregnant patients during the third trimester. Study Design Healthy pregnant women who underwent elective term cesarean sections were included. A noninvasive cardiac output monitor was used to measure hemodynamic variables at baseline and after administration of a 500-mL crystalloid bolus. Results Forty-five women were included in the study. Fluid administration was associated with a statistically significant increase in SV from a baseline value of 71 ± 11 to 90 ± 19 mL (95% confidence interval [CI]: 13.67–21.49; p < 0.01) and a significant decrease in maternal heart rate from a baseline of 87 ± 9 beats per minute to 83 ± 8 after the fluid bolus (95% CI: −6.81 to −2.78; p = 0.03). No changes in peripheral vascular resistances or any other measured hemodynamic parameters were noted with volume expansion. Conclusion In healthy term pregnancy, the heart operates in the ascending portion of the Starling's curve, rendering it fluid responsive.

Transvaginal sonographic assessment of cervical dynamics during the third trimester of normal pregnancy

1997 ◽  
Vol 76 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Geoffrey M. Brieger ◽  
Xie Hong Ning ◽  
Robert R. Dawkins ◽  
Kong Qiu Ying ◽  
Cai Weng ◽  
...  
Keyword(s):  
Normal Pregnancy ◽  
Third Trimester ◽  
The Third ◽  
Sonographic Assessment

Favorable pregnancy outcomes following continual intramuscular lorazepam use in late pregnancy

2013 ◽  
Vol 3 (2) ◽  
pp. 96-98
Author(s):  
Karen E. Moeller
Keyword(s):  
Case Report ◽  
Pregnancy Outcomes ◽  
Late Pregnancy ◽  
Pregnant Patient ◽  
High Dose ◽  
Third Trimester ◽  
The Third

Use of benzodiazepines during pregnancy is controversial due to conflicting studies in the literature. Furthermore, few published reports on continual use of parenteral benzodiazepines during the third trimester of pregnancy have been published. This case report evaluates the use of high-dose intramuscular lorazepam in a pregnant patient during her last three weeks of gestation.

The radioimmunoassay of placental protein 5 and circulating levels in maternal blood in the third trimester of normal pregnancy

1979 ◽  
Vol 95 (3) ◽  
pp. 509-516 ◽  
Author(s):  
B. Obiekwe ◽  
Diana J. Pendlebury ◽  
Y.B. Gordon ◽  
J.G. Grudzinskas ◽  
T. Chard ◽  
...  
Keyword(s):  
Normal Pregnancy ◽  
Maternal Blood ◽  
Third Trimester ◽  
The Third ◽  
Placental Protein ◽  
Circulating Levels

Nuclear thyroxine and 3,5,3'-triiodothyronine receptors in human mononuclear blood cells during pregnancy

1984 ◽  
Vol 105 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Jan Kvetny ◽  
Henning Kvist Poulsen
Keyword(s):  
Blood Cells ◽  
Binding Capacity ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
Serum Free ◽  
The Third ◽  
Nuclear Binding ◽  
Mononuclear Blood Cells ◽  
Tsh Levels

Abstract. Serum free T4, free T3, TSH and maximal nuclear binding capacity for T4 and T3 in mononuclear blood cells were measured in 12 control women, in 12 normal pregnant women in the first and in 12 women in the third trimester. Serum free T4 and T3 were decreased in late pregnancy compared to control women, serum free T4: 9.1 pmol/l (mean) vs 12.9 pmol/l (mean); serum free T3: 4.0 pmol/l (mean) vs 6.2 pmol/l (mean), without any change in TSH levels: 2.2 mU/l (mean) vs 1.8 mU/l (mean). Concomitantly, the maximal nuclear binding capacity for both T4 and T3 increased, T4: 2.7 fmol T4/100 μg DNA vs 1.8 fmol T4/100 μg DNA; T3: 2.8 fmol T3/100 μg DNA vs 2.0 fmol T3/100 μg DNA. These data, obtained from healthy women during a normal pregnancy are compatible with mild compensated hypothyroidism. We suggest that euthyroidism are maintained by the increased maximal nuclear binding capacity for these hormones.

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