Laboratory reference intervals during pregnancy, delivery and the early postpartum period

Abstract

Background: Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological conditions. Methods: Eight hundred and one women with expected normal pregnancies were included in the study. Of these, 391 had no complications during pregnancy, delivery, or the early postpartum period. Blood samples were obtained at gestational weeks 13-20, 21-28, 29-34, 35-42, at labor, and 1 and 2 days postpartum. Reference intervals were calculated for 36 tests as recommended by the International Federation of Clinical Chemistry and Laboratory Medicine. Results: Many tests showed such large variations indicating that gestational age-specific reference intervals were necessary. Other tests had different but stable values when compared to non-pregnant women. A minor decrease in albumin levels was observed. This was not only due to pregnancyassociated hemodilution, since other components with the same or a larger molecular diameter did not show a similar decrease. Many tests exhibited a broad distribution around vaginal delivery and in the early postpartum period. Conclusions: Only a few parameters were unaffected during uncomplicated pregnancy, delivery, and the early postpartum period suggesting that implementation of gestational agespecific reference intervals is necessary. Clin Chem Lab Med 2010;48:237-48.

Persistent organic pollutants and haematological markers in Greenlandic pregnant women: the ACCEPT sub-study

“…Due to physiological changes and general maternal health, the haematological markers change during pregnancy [22,35]. Moreover, the haematological markers are an important diagnostic tool, e.g.…”

“…n : number of participants with data to the corresponding parameter.Missing data: N – n .General reference range listed with reference to: a local recommendation for the Central Laboratory at Queen Ingrid Hospital, Greenland, b [22], c [23], d [24], e [25]. …”

“…When the reference range was not given from The Central Laboratory at QIH, the parameter was listed with the reference range to several relevant laboratory studies; 1) a study including Danish pregnant women [22]; 2) a database review for maternal laboratory studies [23]; 3) a study regarding platelet markers in pregnant women [24]; and 4) a reference range for RDW for healthy adults [25]. For BASO, EO, LYMPH, MONO, and NEU count, the data were presented in 109/L.…”

Are There any Predictive Values of Mean Platelet Volume (MPV) and MPV/Platelet Count Ratio in Patients with Spontaneous Abortion?

“…The laboratory reference intervals were usually based on the results of tests obtained in healthy or non-pregnant women. This is not optimal, as many biological markers change during pregnancy, and using the most appropriate reference values is necessary to make correct clinical decisions (5)(6)(7)(8).…”

Фибринолитическая Активность Крови На Разных Сроках Физиологически Протекающей Беременности

“…Можно констатировать и то, что, несмотря на имеющиеся публикации, Фибринолитическая активность крови на разных сроках физиологически протекающей беременности касающиеся нормативных значений показателей системы фибринолиза при физиологической беременно сти [3,9,10], данных в этой области крайне мало.…”