The association of antenatal D-dimer and fibrinogen with postpartum hemorrhage and intrauterine growth restriction in preeclampsia

Abstract

Background D-dimer and fibrinogen were verified to be altered in preeclampsia. This study was to evaluate the associations of D-dimer and fibrinogen plasma levels with postpartum hemorrhage or intrauterine growth restriction in preeclamptic women. Methods This was a retrospective study that recruited 278 preeclamptic women with singleton pregnancy from January 2016 to December 2019. Patients were allocated into five groups: mild preeclampsia (mPE) (n=68), mild preeclampsia with postpartum hemorrhage (mPE+PPH) (n=13), severe preeclampsia (sPE) (n=112), severe preeclampsia with postpartum hemorrhage (sPE+PPH) (n=17) and severe preeclampsia with intrauterine growth restriction (sPE+IUGR) (n=68). The antenatal D-dimer and fibrinogen plasma levels were analyzed among the groups. Logistic regression was used to determine the correlation between serum indexes and PPH or IUGR in preeclampsia. Results The antenatal D-dimer plasma levels were significantly higher in the sPE+PPH group than that in the sPE group (2.02 μg/ml versus 1.37 μg/ml, P = 0.001), but there was no difference in fibrinogen. Elevated D-dimer was associated with PPH among severe preeclamptic women (adjusted odds ratio (aOR) [95% CI]: 3.093 [1.527-6.264], P = 0.002). No differences in D-dimer and fibrinogen were found between the mPE and mPE+PPH groups or between the sPE and sPE+IUGR groups. Conclusions Elevated antenatal plasma D-dimer level may be associated with postpartum hemorrhage in severe preeclampsia, but not with intrauterine growth restriction. Future prospective clinical trials are needed to investigate the predictive value of D-dimer in postpartum hemorrhage in severe preeclampsia.

Model construction and application for predicting pre-eclampsia by Sonoclot coagulation analyzer

“…Damaged vascular endothelium and imbalances in the three major systems including the coagulation, anticoagulation, and fibrinolysis are currently thought to be related to the incidence of PE [ 18 , 21 , 22 ]. Several studies [ [23] , [24] , [25] ] have shown that coagulation-related indicators alter in PE-affected women, however conventional coagulation tests only provide data on a specific, discrete element of the coagulation process, which is insufficient for comprehending the entire coagulation process. By contrast, the Sonoclot coagulation analyzer can rapidly and conveniently monitor the entire coagulation process in a small amount of serum [ 5 ].…”

Establishment of a predictive model for postpartum hemorrhage in twins: a retrospective study

“…Pregnancies in twins are particularly susceptible to HDP, and it makes PPH more at risk [20]. HDP causes spasms of systemic small blood vessels, and abnormal blood flow to the uterine placenta, leading to uterine myxedema, in addition, antihypertensive drugs in the clinic may reduce the excitability of uterine muscle fibers, leading to compromised uterine contractile function and increased PPH risk.…”

Diagnostic and Prognostic Value of Deregulated Long Non-Coding RNA Plasmacytoma Variant Translocation 1 in Patients with Gestational Hypertension

“…Without effective control and treatment, severe cases may lead to convulsions, coma, and even maternal and infant death (Wang et al 2019b). The worldwide incidence of HDP is about 4.6%, which is one of the main reasons that affect the health and mortality of pregnant women and perinatal infants (Shao et al 2021). According to the study, HDP patients and their offspring have significantly increased incidence of cardiovascular and nervous system diseases compared with normal pregnant women (Hou et al 2020).…”