Seminars in Vascular Medicine 2005; 05(4): 375-378
DOI: 10.1055/s-2005-922483
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

D-Dimer Testing in Pregnancy

Sabine Eichinger1
  • 1Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
Further Information

Publication History

Publication Date:
22 November 2005 (online)

ABSTRACT

Normal pregnancy is associated with alterations of the hemostatic system toward a hypercoagulable state. Elevated markers of coagulation and fibrinolytic system activation, such as D-dimer, indicate increased thrombin activity and increased fibrinolysis following fibrin formation throughout pregnancy. Testing for D-dimer in pregnant women could be useful for the diagnosis and prediction of a venous thromboembolic event or pregnancy-related complications and for monitoring antithrombotic treatment. This approach, however, is hampered by the fact that even an uncomplicated pregnancy in healthy women is accompanied by a substantial increase of D-dimer. Thus, prior to clinical application reference values of D-dimer according to gestational age need to be validated. A substantial increase of D-dimer during pregnancy is seen despite thromboprophylaxis with low-molecular-weight heparin (LMWH), indicating that further studies are needed to evaluate monitoring of LMWH during pregnancy and to investigate the optimal beginning and dose of LMWH thromboprophylaxis in pregnant women.