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Explanation of analyzes

D-dimer: the norm during pregnancy, raised and lowered

Fetching a child forces the woman's body to produce an increased amount of platelets. This is a natural process, because the body of the future mother is prepared for the forthcoming birth and, as a result, great blood loss.

However, strong deviations in blood coagulation rates from normal can provoke intrauterine fetal death or premature birth, so patients with genetic diseases of the blood take an analysis for the d-dimer in order to identify possible thromboses.

D-dimer is the product of the decay of the blood clot - the higher its value, the greater the probability of increased clotting and blood clots in the blood vessels of the placenta.

How is the D-dimer formed?

D-dimer in pregnancy

In an organism genetically predisposed to clots, clots of blood can form not only on the surface of wounds, but also inside the vessels. The composition of thrombi includes a protein fibrin, which keeps the components of the blood clot together. To normalize the situation and adjust the blood supply to the body, the brain triggers processes whose action is directed to the destruction of the blood clot.

Fibrin begins to disintegrate and the result is the formation of D-dimers. The more clots, the more active the organism tries to destroy them. Means, the more in blood will be found out products of disintegration of blood clots if at the patient blood for research will be taken.


Normal value of D-dimer in pregnancy, table

Normally, D-dimer in pregnancy, up to 13 weeks, remains within the reference values ​​that are characteristic of women who do not bear a child. That is, they do not exceed 0. 55 μg FEU / mL.

The absence of changes is explained quite simply: in the first trimester the placenta has not yet been fully formed, and in fact the increase in the values ​​of d-dimer during pregnancy is most often associated with the dysfunction of the operation of the vessels of the membranes.

Then the placenta ripens and the reference values ​​of the decomposition products of the blood clots increase, making up, in norm, no more than 1.4 μg FEU / ml (up to 21 weeks of pregnancy). In this case, an insignificant increase in the indices of d-dimer is natural, since the body begins to prepare the circulatory system for childbirth.

As the placenta ages, the indices of the product of the disintegration of blood clots continue to increase. A variant of the norm will be if the blood test at the 29th week shows values ​​not exceeding 1.7 μg FEU / ml, and before the birth - not exceeding 3.1 μg FEU / ml.

If the doctor monitors blood clotting in the patient throughout the whole period, then the tests can be prescribed much more often. In this case, it will be possible to compare the norms of the d-dimer according to tables designed specifically to evaluate the results of the analysis in pregnant women.

D-dimer in pregnancy, table
Week of pregnancy Reference values ​​(μg FEU / ml)
up to 13 weeks 0 - 0.55
13 - 21 0.2 - 1.4
21 - 29 0.3 - 1.7
29 - 35 0.3 - 3
35 and onwards 0.4 - 3.1

Elevated levels of d-dimer in pregnancy

Elevated levels of d-dimer in pregnancy

If the values ​​of the decay product of blood clots are increased, this indicates the presence of thrombi. Especially, a sharp increase in this blood indicator should be guarded - this means that the patient needs urgent hemorrhage therapy.

The main disadvantage for physicians is that the analysis can only ascertain - in pregnancy, d-dimer is elevated, but it will remain completely unclear which blood vessels are actively involved in thrombus formation.

Based on the results of the analysis, the doctor will propose additional tests to the pregnant woman in order to understand the reason for the deviation from the norm of the product index of decomposition of blood clots. Among them may be:

  • Doppler scan of placental blood flow - in most cases, a high d-diameter during pregnancy is due to dysfunction of the blood vessels that feed the placenta.
  • Oncological markers - if the increase in protein is gradual and insignificant, and the results of the Doppler study did not reveal any problems, the patient may be referred for blood testing to determine the presence of malignant processes in the body.
  • Kidney ultrasound - an increase in the d-dimmer is associated with renal dysfunction. With an increase in the gestation period, the body becomes increasingly difficult to control the chemical homeostasis.

The lowered level of the d-dimmer

Doctors say that cases when the d-dimmer in a pregnant woman falls below the norm are very rare. If the analysis reveals such a problem, then the obstetrician-gynecologist faces a difficult task: for the time remaining before delivery, the patient should be prescribed such therapy courses that will lead to a relative order of blood coagulability.

Otherwise, postpartum bleeding will become a serious threat to the life of a woman.

If the g-dimer is lowered - the gynecologist is obliged to send the patient to the hematologist for further examination and recommendations regarding the correction of the condition.

Monitoring blood clotting indicators is important not only for successful labor, but also for bearing a child. The higher the value of the g-dimmer, the worse the fetal nutrition. The result is the appearance of hypoxia and a common intrauterine lag in weight and height.

How to prepare for the analysis?

To study the blood must be taken from the vein, so usually the procedure is carried out in the morning and warned that the patient must come to the clinic on an empty stomach. In addition, when collecting material for determining the d-dimer, there are special rules:

  • You need to refrain from smoking for an hour before taking blood. Smoking provokes the formation of blood clots, so the absence of abstinence within the prescribed time can seriously affect the results of the study.
  • It is necessary not to eat fatty foods within a day. It provokes an increase in the level of cholesterol in the blood, which also distorts the blood counts.
  • The day before the analysis, you should take care of yourself from nervous shocks that can affect the level of the d-dimer.

The results of the study are usually ready in 3 working days, but for each laboratory the processing time is individual, so it is better to clarify this question in the registry of the clinic that you applied to.


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