scholarly journals Profile of D-dimer in Uncomplicated Pregnancy

Author(s):  
Rahajuningsih Dharma ◽  
Mercy T. Panjaitan ◽  
Kanadi Sumapradja ◽  
Rianto Setiabudy

Abstract Objective: To obtain the profile of D-dimer in uncomplicated pregnancy. Methods: A cross sectional study was done on 90 uncomplicated pregnant women consisted of 30 women in each trimester and 30 healthy, nonpregnant women as control group from July to August 2012. D-dimer level was measured by particle enhanced immunoturbidimetry method using Innovance D-dimer and Sysmex CA 1500 in the Department of Clinical Pathology, Dr. Cipto Mangunkusumo Hospital, Jakarta. Results: All women in the control group showed normal D-dimer level (<0.,5 mg/L FEU). The median and range of D-dimer level in the 1st trimester, 2nd trimester, and 3rd trimester were 0.42 mg/L FEU and 0.1-1.07 mg/L FEU, 0.97 mg/L FEU and  0.6-3.34 mg/L FEU, and 1.56 mg/L FEU and  0.69-3.75 mg/L FEU, respectively.  Increased D-dimer level was found in 27% of pregnant women in 1st trimester, 87% in 2nd trimester, and 100% in 3rd trimester. Conclusion: Increased D-dimer level was found in  27% of pregnant women in 1st trimester, 87% in 2nd trimester, and  100% in 3rd trimester. The range of D-dimer level in the 1st trimester was 0.1-1.07 mg/L FEU, in the 2nd trimester was 0.6-3.34 mg/L FEU, and in the 3rd trimester was 0.69-3.75 mg/L FEU. Keywords: D-dimer, trimester, uncomplicated pregnancy   Abstrak Tujuan : Untuk mendapatkan profil  D-dimer pada kehamilan tanpa komplikasi. Metode : Penelitian potong lintang dilakukan pada 90 perempuan hamil tanpa komplikasi yang terdiri atas 30 perempuan pada tiap trimester dan 30 perempuan sehat yang tidak hamil, sebagai kelompok kontrol dari bulan Juli sampai Agustus 2012. Kadar D-dimer diukur dengan cara particle enhanced immunoturbidimetry  menggunakan reagen InnovanceÒ D-dimer dan koagulometer SysmexÒ CA 1500 di  Deparemen Patologi Klinik, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Hasil: Seluruh perempuan dalam kelompok kontrol mempunyai kadar D-dimer dalam batas normal (<0.,5 mg/L FEU). Median (rentang) kadar D-dimer  pada trimester pertama, kedua, dan ketiga berturut-turut  0.42 mg/L FEU  (0.1-1.07 mg/L FEU), 0.97 mg/L FEU (0.6-3.34 mg/L FEU), dan 1.56 mg/L FEU   (0.69-3.75 mg/L FEU).  Peningkatan kadar D-dimer ditemukan pada 27% perempuan hamil trimester pertama, 87%  trimester kedua, dan pada 100%  trimester ketiga.   Kesimpulan: Peningkatan kadar  D-dimer ditemukan pada  27% perempuan hamil trimester pertama,  87% trimester kedua dan   100% pada trimester ketiga.  Rentang kadar D-dimer level pada trimester pertama adalah 0.1-1.07 mg/L FEU, pada trimester kedua  0.6-3.34 mg/L FEU, dan pada trimester ketiga  0.69-3.75 mg/L FEU. Kata kunci: D-dimer, kehamilan tanpa komplikasi, trimester

2016 ◽  
Vol 9 (2) ◽  
pp. 78-82
Author(s):  
NM Murphy ◽  
AS Khashan ◽  
DI Broadhurst ◽  
O Gilligan ◽  
K O’Donoghue ◽  
...  

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.


Author(s):  
Laxmi Poonia ◽  
Swati Kochar ◽  
Shweta Chaudhary ◽  
Priyanka Gaur ◽  
Kirti Solanki

Background: Hypertensive disorders of pregnancy, including preeclampsia complicates about 10% of pregnancies worldwide. Preeclampsia is one of the major cause of maternal and perinatal morbidity and mortality worldwide. According to the National Health Portal of India, the incidence of preeclampsia is reported to be about 8-10% among pregnant women. The present study was aimed to compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation and assess relationship between maternal serum calcium levels, severity of disease and overall maternal and perinatal outcome.Methods: This was a cross sectional study conducted on 200 females divided into two groups (i.e. Study and Control Group) from 1st November 2019 to 31st October 2020. Informed consent was obtained for subjecting. Detailed history and clinical examination were performed. Serum calcium level was measured in both groups by spectrophotometric method.Results: Mean serum calcium level in study group (preeclamptic) was 7.84+0.74mg/dl while in control group (normotensive) mean serum calcium level was 9.68+0.97mg/dl. Serum calcium level was significantly lower in preeclamptic women than normotensive pregnant women (p<0.001).Serum calcium showed significant negative correlation with systolic and diastolic blood pressure.Conclusions: This study concludes that hypocalcaemia may have a role in aetiology of preeclampsia and adverse maternal and perinatal outcome. Thus intake of calcium supplements may help in reduction of incidence of preeclampsia especially in a population of a developing country. 


2021 ◽  
Author(s):  
Mahshid Gharagozloo ◽  
Shahideh Jahanian Sadatmahalleh ◽  
Mahnaz Bahri Khomami ◽  
Ashraf Moini ◽  
Anoshirvan Kazemnejad

Abstract Background: Women' mental health during reproductive age is a major public health concern in both developing and developed countries. There is a relationship between mental health and marital satisfaction. This study aimed to assess mental health, anxiety, depression, and marital satisfaction among pregnant and lactating women and compared the results with non-pregnant/lactating (as control group) during the COVID-19 pandemic in Iran. Methods: A cross-sectional study among married women in range of 18 to 45 years via online questionnaires was conducted from 20 March to 25 April, 2020. A total of 604 valid questionnaires were analyzed, including 200 pregnant women, 203 lactating women, and 201 non-pregnant/lactating women. Mental health, COVID-19-related anxiety, and marital satisfaction were respectively assessed by the General Health Questionnaire (GHQ), the Corona Disease Anxiety Scale (CDAS), and ENRICH Marital Satisfaction Scale (EMS Scale). The data were analyzed using Statistical Package for Social Sciences (SPSS) software. Results: The scores of mental health problems in pregnant and lactating women were significantly higher than the control group (18.86±12.56 and 18.83±13.99 vs. 13.01±8.15, P<0.00). The total CDAS score in the control group was significantly less than pregnant women (30.87±10.56 vs. 26.05±6.12, P<0.001) and lactating women (30.80±11.37 vs. 26.05±6.12, P<0.001). The mean of marital satisfaction was significantly lower in the pregnant women (28.06±2.67 vs. 29.64±3.18, P < 0.001) and lactating women (28.74±3.58 vs. 29.64±3.18, p = 0.01) compared with the control group. There was no statistically significant difference in the depression among three groups (P < 0.05).Conclusions: Pregnant and lactating women had more mental health problems, more anxiety and less marital satisfaction in comparison to non-pregnant/lactating women in the course of COVID-19 outbreaks. Further study is needed to investigate the effect of COVID-19 prevalence on mental health and marital satisfaction of pregnant and lactating women, considering the socioeconomic status.


Author(s):  
Quratul-Ain Zafar

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.


2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.


Author(s):  
Katarzyna Kwiatkowska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Izabela Walasik ◽  
Agnieszka Osińska ◽  
Iwona Szymusik

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.


2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.


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