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D-dimer Pregnancy

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https://www.readbyqxmd.com/read/29782079/the-dipep-diagnosis-of-pe-in-pregnancy-study-an-observational-study-of-the-diagnostic-accuracy-of-clinical-assessment-d-dimer-and-chest-x-ray-for-suspected-pulmonary-embolism-in-pregnancy-and-postpartum
#1
Steve Goodacre, Kimberley Horspool, Catherine Nelson-Piercy, Marian Knight, Neil Shephard, Fiona Lecky, Steven Thomas, Beverley J Hunt, Gordon Fuller
OBJECTIVE: To identify clinical features associated with PE diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women. DESIGN: Observational cohort study augmented with additional cases. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites and maternity units in the United Kingdom Obstetric Surveillance System (UKOSS). POPULATION: 324 pregnant/postpartum women with suspected PE and 198 pregnant/postpartum women with diagnosed PE...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29504087/the-diagnostic-utility-of-d-dimer-and-other-clinical-variables-in-pregnant-and-post-partum-patients-with-suspected-acute-pulmonary-embolism
#2
Hyun Choi, Dinesh Krishnamoorthy
BACKGROUND: Pulmonary embolism (PE) during pregnancy remains one of the leading causes of maternal morbidity and mortality in the developed world. However, there is a paucity of high-quality evidence resulting in a lack of consensus in managing this group of patients. The aims of the study were to address the diagnostic utility of D-dimer for suspected PE in pregnant and post-partum patients and to identify any clinical presentation variables that are predictors of PE in this group of patients...
March 5, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29359796/the-dipep-diagnosis-of-pe-in-pregnancy-biomarker-study-an-observational-cohort-study-augmented-with-additional-cases-to-determine-the-diagnostic-utility-of-biomarkers-for-suspected-venous-thromboembolism-during-pregnancy-and-puerperium
#3
Beverley J Hunt, Kiran Parmar, Kimberley Horspool, Neil Shephard, Catherine Nelson-Piercy, Steve Goodacre
This study aimed to estimate the diagnostic utility of biomarkers for suspected venous thromboembolism (VTE) in pregnancy and the puerperium. Research nurses/midwives collected blood samples from 310 pregnant/postpartum women with suspected pulmonary emboli (PE) and 18 with diagnosed deep vein thrombosis (DVT). VTE was diagnosed using imaging, treatment and adverse outcome data. Primary analysis was limited to women with conclusive imaging (36 with VTE, 247 without). The area under the curve (AUC) for each biomarker was: activated partial thromboplastin time 0·669 (95% confidence interval 0·570-0·768), B-type natriuretic peptide 0·549 (0·453-0·645), C-reactive protein 0·542 (0·445-0·639), Clauss fibrinogen 0·589 (0·476-0·701), D-Dimer (by enzyme-linked immunosorbent assay) 0·668 (0·561-0·776), near-patient D-Dimer 0·651 (0·545-0·758), mid-regional pro-atrial natriuretic peptide 0·524 (0·418-0·630), prothrombin fragment 1 + 2 0·562 (0·462-0·661), plasmin-antiplasmin complexes 0·639 (0·536-0·742), prothombin time 0·613 (0·508-0·718), thrombin generation lag time 0·702 (0·598-0·806), thrombin generation endogenous potential 0·559 (0·437-0·681), thrombin generation peak 0·596 (0·478-0·715), thrombin generation time to peak 0·655 (0·541-0·769), soluble tissue factor 0·531 (0·424-0·638) and serum troponin 0·597 (0·499-0·695)...
March 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29303769/reference-intervals-for-biochemical-haemostatic-and-haematological-parameters-in-healthy-chinese-women-during-early-and-late-pregnancy
#4
Yi Jin, Jie Lu, Hong Jin, Chunrong Fei, Xinyou Xie, Jun Zhang
BACKGROUND: Variations in maternal blood parameters, which are mostly induced by the physiological changes that occur during pregnancy, have been reported in different gestational periods. The use of the established reference intervals for healthy adult females leads to the misclassification of healthy pregnant women as abnormal. Our aim was to establish appropriate reference intervals for biochemical, haematological and haemostatic parameters in the first and third trimesters of pregnancy...
January 5, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29184862/the-clinical-significance-of-d-dimer-concentrations-in-patients-with-gestational-hypertensive-disorders-according-to-the-severity
#5
Se Jeong Kim, Hyo Jeong Ahn, Jung Yeon Park, Byoung Jae Kim, Kyu Ri Hwang, Taek Sang Lee, Hye Won Jeon, Sun Min Kim
Objective: Pregnancy is a major risk factor of thromboembolism, and the patients with preeclampsia (PE) are known to have higher risk of thromboembolic complications than normal pregnant women. D-dimer is a well-established laboratory marker for the screening of venous thromboembolism (VTE), but the concentrations of d-dimer tend to increase physiologically in pregnant women throughout the gestational age. We performed this study to evaluate the clinical significance of d-dimer concentrations in patients with gestational hypertensive disorders (GHD) according to the severity...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29170324/27-the-dipep-diagnosis-of-pe-in-pregnancy-study-can-clinical-assessment-d-dimer-or-chest-x-ray-be-used-to-select-pregnant-or-postpartum-women-with-suspected-pe-for-diagnostic-imaging
#6
Steve Goodacre, Kimberley Horspool, Catherine Nelson-Piercy, Marian Knight, Neil Shephard, Fiona Lecky, Steven Thomas, Beverley Hunt, Gordon Fuller
OBJECTIVE: To determine whether clinical features (in the form of a clinical decision rule) or d-dimer can be used to select pregnant or postpartum women with suspected PE for diagnostic imaging. DESIGN: Observational cohort study augmented with additional cases. SETTING: Consultant-led maternity units participating in the UK Obstetric Surveillance System (UKOSS) and emergency departments and maternity units at eleven prospectively recruiting sites...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170316/19-accuracy-of-biomarkers-for-venous-thromboembolism-in-pregnancy-the-diagnosis-of-pulmonary-embolism-in-pregnancy-dipep-biomarker-study
#7
Steve Goodacre, Beverley Hunt, Kiran Parmar, Neil Shephard, Kimberley Horspool
OBJECTIVE: To estimate the accuracy of biomarkers for venous thromboembolism (VTE) in pregnant and postpartum women with suspected pulmonary embolism (PE). DESIGN: Observational cohort study augmented with additional cases with VTE. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites. PARTICIPANTS: Pregnant or postpartum women presenting with suspected PE or diagnosed DVT. INTERVENTIONS: Research nurses/midwives collected a blood sample from women with suspected PE or diagnosed DVT and data relating to diagnostic imaging, treatment and adverse outcomes...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29032523/thrombin-generation-test-as-a-marker-for-high-risk-venous-thrombosis-pregnancies
#8
Bérangère S Joly, Bénédicte Sudrié-Arnaud, Virginie Barbay, Jeanne-Yvonne Borg, Véronique Le Cam Duchez
Pregnancy is a well-established risk factor for venous thromboembolism and is associated with a state of hypercoagulability. The use of sensitive and specific biological markers to predict risk factors for thrombosis is essential during pregnancy. Our objective was to investigate the usefulness of thrombin generation test (TGT) as a marker to predict the risk of thrombosis in high risk venous thrombosis (HRVT) pregnancies compared to normal pregnancies. This retrospective study enrolled 134 women with HRVT pregnancies, 78 of whom had monozygotic, spontaneous and untreated pregnancies and formed the study group...
January 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29024233/use-of-d-dimer-measurement-to-guide-anticoagulant-treatment-in-recurrent-pregnancy-loss-associated-with-antiphospholipid-syndrome
#9
Shi Hua Bao, Shi Le Sheng, Hong Liao, Qian Zhou, Sophia Twum Frempong, Wei Yan Tu
PROBLEM: To examine whether the level of plasma D-dimer can guide anticoagulant treatment in recurrent pregnancy loss (RPL) associated with antiphospholipid syndrome (APS). METHODS: A total of 1096 RPL women with APS between 2012 and 2015 in a single-center hospital were randomly divided into two groups (group A, 75 mg of low-dose aspirin [LDA] daily; group B, 75 mg of LDA plus 4100 U of low molecular weight heparin [LMWH] subcutaneously daily); 1015 of the total successfully completed the trial...
December 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28935434/diagnosis-of-venous-thromboembolism-in-pregnancy
#10
Wee-Shian Chan
The diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) during pregnancy still relies on objective imaging. Ancillary testing such as clinical prediction rules and D-dimer testing may have a role in excluding both DVT and PE in these pregnant patients even as we await results from prospective management studies. The anatomical distribution of DVT in pregnancy differs from those in non-pregnant patient with a greater propensity for proximal iliac vein thrombosis. Using leg ultrasonography with compression maneuvers from the femoral vein to popliteal vein and doppler assessment of the iliac vein in a single examination, appears adequate in most pregnant women with suspected DVT, in excluding DVT...
September 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28605659/trimester-specific-coagulation-and-anticoagulation-reference-intervals-for-healthy-pregnancy
#11
Chanjuan Cui, Shuo Yang, Jie Zhang, Guojing Wang, Shengkai Huang, Aiwei Li, Yuncong Zhang, Rui Qiao
BACKGROUND: Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China. METHODS: In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28583609/global-hemostasis-in-healthy-bitches-during-pregnancy-and-at-different-estrous-cycle-stages-evaluation-of-routine-hemostatic-tests-and-thromboelastometry
#12
Sigal Klainbart, Alexandra Slon, Efrat Kelmer, Tali Bdolah-Abram, Tal Raz, Gilad Segev, Itamar Aroch, Smadar Tal
This study assessed the global hemostasis (including prothrombin time [PT], activated partial thromboplastin time [aPTT], antithrombin activity [ATA], fibrinogen and d-Dimer concentrations, platelet count, plateletcrit and thromboelastometry) in healthy pregnant bitches, comparing the results with those of healthy bitches at different estrous cycle stages, and assessed whether hemostatic changes during pregnancy are associated with serum progesterone concentration or the presence of fetuses in utero. The results show that pregnant bitches have higher fibrinogen concentration, platelet count and platelatecrit, and that fibrin and global clot formations occur faster than in non-pregnant bitches at different estrous cycle stages...
July 15, 2017: Theriogenology
https://www.readbyqxmd.com/read/28504829/prediction-of-thrombophilia-in-patients-with-unexplained-recurrent-pregnancy-loss-using-a-statistical-model
#13
Tongfei Wang, Xiaomin Kang, Liying He, Zhilan Liu, Haijing Xu, Aimin Zhao
OBJECTIVE: To establish a statistical model to predict thrombophilia in patients with unexplained recurrent pregnancy loss (URPL). METHODS: A retrospective case-control study was conducted at Ren Ji Hospital, Shanghai, China, from March 2014 to October 2016. The levels of D-dimer (DD), fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), and platelet aggregation in response to arachidonic acid (AA) and adenosine diphosphate (ADP) were collected...
September 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28360822/impact-of-blood-hypercoagulability-on-in-vitro-fertilization-outcomes-a-prospective-longitudinal-observational-study
#14
Grigoris T Gerotziafas, Patrick Van Dreden, Emmanuelle Mathieu d'Argent, Eleftheria Lefkou, Matthieu Grusse, Marjorie Comtet, Rabiatou Sangare, Hela Ketatni, Annette K Larsen, Ismail Elalamy
BACKGROUND: Blood coagulation plays a crucial role in the blastocyst implantation process and its alteration may be related to in vitro fertilization (IVF) failure. We conducted a prospective observational longitudinal study in women eligible for IVF to explore the association between alterations of coagulation with the IVF outcome and to identify the biomarkers of hypercoagulability which are related with this outcome. METHODS: Thirty-eight women eligible for IVF (IVF-group) and 30 healthy, age-matched women (control group) were included...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#15
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#16
REVIEW
Clive Kearon
The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27720446/use-of-clinical-prediction-rules-and-d-dimer-tests-in-the-diagnostic-management-of-pregnant-patients-with-suspected-acute-pulmonary-embolism
#17
REVIEW
L M Van der Pol, A T A Mairuhu, C Tromeur, F Couturaud, M V Huisman, F A Klok
Because pregnant women have an increased risk of venous thromboembolism (VTE) and at the same time normal pregnancy is associated with symptoms, mimicking those present in the setting of acute pulmonary embolism (PE), the latter diagnosis is frequently suspected in this patient category. Since imaging tests expose both mother and foetus to ionizing radiation, the ability to rule out PE based on non-radiological diagnostic tests is of paramount importance. However, clinical decision rules have only been scarcely evaluated in the pregnant population with suspected PE, while D-dimer levels lose diagnostic accuracy due to a physiological increase during normal pregnancy...
March 2017: Blood Reviews
https://www.readbyqxmd.com/read/27671047/-study-on-the-dynamic-changes-of-d-dimer-during-pregnancy-and-early-puerperium
#18
D Xu, S P Cai, J W Xu, C Liang, J He
Objective: To explore the dynamic changes of D-dimers during pregnancy and early puerperium(within 3 days postpartum). Methods: A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women's Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy(≤12 gestation weeks), middle pregnancy(12-28 gestation weeks), late pregnancy(>28 gestation weeks), 1 postpartum(within 48 hours postpartum)and 2 postpartum(48- 72 hours postpartum)...
September 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27592487/clinical-study-on-the-influence-of-phloroglucinol-on-plasma-angiotensin-ii-and-d-dimer-index-in-patients-with-severe-pregnancy-induced-hypertension
#19
RANDOMIZED CONTROLLED TRIAL
Liang Ai, Xinzhi Lan, Limin Wang, Yanjie Xu, Bin Zhang
To observe the effect of phloroglucinol on plasma angiotensin II and D-dimer index when it was applied to patients with severe pregnancy-induced hypertension. 212 cases of severe pregnancy-induced hypertension patients diagnosed clinically were selected to be randomly divided into the research group and the control group. The research groups were given phloroglucinol, while the control groups were given magnesium sulfate. The plasma angiotensin II and D-dimer index in patients were detected before treatment and after 7 days respectively with statistical analysis of results...
July 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27512498/perinatal-determinants-of-d-dimer-levels-in-a-cross-sectional-study-of-low-risk-pregnant-women
#20
N M Murphy, A S Khashan, D I Broadhurst, O Gilligan, K O'Donoghue, L C Kenny
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...
June 2016: Obstetric Medicine
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