Challenges in the evaluation of D-dimer and fibrinogen levels in pregnant women

Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

“…This suggests that D-dimer has no practical diagnostic use in pregnancy if the threshold for abnormal of 0.55 mg/L is used (cut-off out of pregnancy). The obtained results from this study are in accordance with our previously reported study and studies that included different population of pregnant women [14][15][16][17][18].…”

“…However, investigation of D-dimer among healthy pregnant women in different populations showed gradual increase of D-dimer which correlates with the gestational age; however, reference range varied depending on the D-dimer test (type, its sensitivity and specificity) [14][15][16][17][18], while the data about thrombin generation in normal pregnancy were scarce and conflicting [19,20].…”

Use of D‐dimer measurement to guide anticoagulant treatment in recurrent pregnancy loss associated with antiphospholipid syndrome

“…As reported by previous studies, the plasma D‐dimer level progressively increases throughout the whole pregnancy at each trimester; however, there is little evidence regarding the changes of D‐dimer level within early pregnancy in healthy women. Baseline D‐dimer values were first collected in the cohort of 93 healthy controls, as described above.…”

Mild factor XIII deficiency and concurrent hypofibrinogenemia

“…Our patient's baseline hypofibrinogenemia increased during pregnancy to within the normal nonpregnant range, but was still significantly below normal pregnancy values. In one study of 80 normal pregnant women, the 2.5th percentile was found to be 430 mg/dl [90% confidence interval (CI) 398, 463], with a mean of 615 mg/dl at 36 weeks gestation [18]. The patient's lower fibrinogen levels remain unexplained.…”