D dimer is elevated during pregnancy, what to do. D-dimer: what is it, analysis and norm, increase and prerequisites for it

Causes of low D-dimer

Since DD may normally be completely absent in a healthy person, a reduced level is difficult to imagine. Low values ​​of the fibrin protein fragment may indicate that there are no blood clots in the body. This may indicate ideal health and the absence of damage to the external and internal tissues of the body. However, there is no need to rush to conclusions.

First, the D-dimer test result may be false negative. This situation is possible when a sample is taken for research before the disintegration of the blood clot and the formation of D-dimer begins, or after the blood clot has broken down and DD has been removed from the bloodstream. Also, the DD level may be lowered if you did not do the analysis on an empty stomach.

Secondly, during pregnancy, low levels of the protein fragment may indicate reduced prothrombin time and poor blood clotting. This means that a woman has a high risk of internal and external bleeding during pregnancy and immediately at the time of childbirth. This pathology is very dangerous and requires attention from you and your doctor.

Thirdly, if, during consultation with a doctor, the patient did not mention that he was taking anticoagulants, then the test result may be negative. It is worth remembering that the test must be carried out on an empty stomach, and it is also important not to take medications twelve hours before the test.

In case of false negative results, the only solution to the problem is to repeat the test. If he detects an excess of D-dimer, then treatment will consist of reducing its level. If the D-dimer is pathologically low in groups of people in whom it should be increased (for example, in women during pregnancy), then this is a reason to first visit a doctor and then start taking liquefying drugs (coagulants, etc.) in order to avoid dangerous complications .

Don't put off solving health problems until the last minute. If you observe any symptoms, feel unwell, or simply doubt your health, do not be lazy to consult a doctor and regularly undergo all necessary tests. Early diagnosis will help you end the war with low-blood disease, which cannot be said about advanced cases.

The D-dimer level during pregnancy (or in other words, the level of blood clotting) is one of the most important indicators for the expectant mother, since a decrease or, conversely, an increase in the level of blood clotting can cause serious complications, among which the most severe is the threat miscarriage.

Therefore, qualified medical specialists monitor blood clotting, as well as the indicators and parameters of this process, throughout pregnancy.

Taking a D-dimer test is not mandatory, but in some cases the doctor directs the woman to take it at least three times during pregnancy

Due to the fact that the process of thrombus formation is a multi-stage and very complex process, it cannot be judged by one or several indicators. Therefore, the D-dimer of pregnancy is displayed according to several different values ​​of the coagulogram, the general condition of the female body, as well as the stage and trimester of pregnancy.

What is D-dimer?

Pregnancy D-dimer levels are the total amount of protein elements in human blood that appear after the complete breakdown of fibrin. If the content of the protein fragment is increased, then blood clotting is increased, which may cause the risk of blood clots during pregnancy. If the content of the protein fragment is reduced, this may cause bleeding.

The appearance of D-dimer in the body is the result of a whole complex of reactions to various damage to blood vessels and tissues:

1. After the integrity of the tissues is disrupted, the element fibrinogen (this is a blood protein that is dissolved in plasma) becomes fibrin;
2. Fibrin (or otherwise insoluble protein) is responsible for the synthesis and formation of polymeric white threads that cover damage;
3. Red blood cells and platelets accumulate in these networks and threads, which is why a clot appears, which is one of the important obstacles to bleeding; Tissue cells divide with great activity and speed, resulting in their rapid healing;
4. Once the clot is no longer needed, it begins to disintegrate.

An important point: the norm of D-dimer during pregnancy is a variable value that is directly dependent on the woman’s age, as well as on general health and the trimester of pregnancy.

How is the D-dimer analysis procedure performed?

If it is necessary to determine the concentration, level and norm of D-dimer of pregnancy, it is necessary to take blood from a vein. It should be noted that it is recommended to arrive early in the morning for the procedure, as you must eat food more than eight hours before the procedure. The only exception is water.

In addition, the use of certain types of medications may negatively or incorrectly affect the results of the studies. That is why it is necessary to warn the doctor and tell him about every medication that was taken in the last 24 hours. It is also recommended to note such information on a special form.

When can tests be ordered?

• if the results and final indicators of the previous study revealed any disorders or deviations in the blood clotting parameter;
• if a woman expecting a child has any diseases that affect the proper functioning of the coagulation system (this could be diseases of the circulatory system, liver, as well as varicose veins and bleeding);
• if a woman has a pathology. Also if a woman has any of the risk factors for pregnancy;
• if the resulting pregnancy is the result of not natural, but artificial insemination;
• if a woman has diseases related to the kidneys, blood vessels, heart, as well as various hormonal and/or autoimmune disorders;
• if a woman has any intoxication and/or bad habits.

Only the doctor decides whether a woman needs to monitor her D-dimer level

The normal levels and indicators of pregnancy D-dimer in women from the groups and categories listed above may differ slightly or very much from all those norms that are generally accepted and standardized. Therefore, in order to correctly interpret the results of the studies in individual cases, it is important to seek advice from a qualified doctor.

Is it worth monitoring the norms and indicators of D-dimer?

Bearing a child is a natural and naturally programmed process, which is accompanied by various changes in hormones and the body. Any changes in the female body that occur during pregnancy are physiological and noticeable, that is, if necessary, they can be tracked using various laboratory and/or instrumental tests. To some extent, during pregnancy, the main aspects of the functioning and functioning of the blood circulation change, and the volume of blood and its circulation becomes larger.

The thing is that the female body is conducting a kind of preparation for the upcoming blood loss. During childbirth, a woman loses about 0.5 liters of blood, so it is extremely important to prevent excessive loss. It is also extremely important for the body of the woman and the child to minimize the possibility of bleeding during pregnancy. All of this can be monitored using D-dimer tests.

Norms for the indicator

In fact, the D-dimer of pregnancy is a variable value that changes in proportion to the period. It is also important to remember: the volume of circulating blood in a pregnant woman’s body increases by 1-1.5 liters during pregnancy, because it is necessary to supply a sufficient amount of oxygen not only to the woman, but also to the child who is inside.

Therefore, at the end of childbirth, closer to the 9th month, the D-dimer norm of pregnancy will be several times higher than the norm at the beginning of pregnancy. You should also remember that all changes will not occur immediately, but gradually.

First trimester. For this period, normal levels of D-dimer are 500-700 ng/ml. It is important to remember that these figures are relative, so it is impossible to judge the state of the body and health of the expectant mother by them. Therefore, in addition to this indicator, the doctor also needs to take into account many other points and factors

There is a possibility of both a serious decrease and a serious increase in the indicators and levels of coagulation. But only a specialist is able to determine the degree of importance and significance of the deviation of indicators from their normal value.

Second trimester. The normal level is 900 ng/ml or lower. It should be noted that this figure is twice as high as the same figure before pregnancy. However, there are practical cases in which the values ​​of the indicators can seriously exceed this limit, although the condition of the fetus and mother does not worsen in any way.

If the indicators are greatly increased for the second trimester, the doctor may prescribe anticoagulant drugs to the expectant mother. Very often, in case of increased indicators, the expectant mother may also be sent to a hospital for observation.

Third trimester. During the third trimester, the D-dimer level may increase to 1500 ng/ml. These are normal indicators for the third trimester, because it is during this period that a woman’s body prepares for the birth of a child.

Sometimes indicators may remain unchanged for two trimesters - this is also one of the normal variants. However, regardless of the indicators, D-dimer levels should increase significantly in the last trimester. If this is not the case, then the doctor needs to conduct a diagnosis and examination.

Increased rate

An increased D-dimer level during pregnancy indicates increased formation of blood clots in the female body. In addition, the massive appearance of blood clots in the body is one of the characteristic signs for such pathologies and diseases in the hemostatic system as:

• DIC syndrome;
• throboembolism;
• hereditary thrombophilia.

Among other things, this indicator increases with the appearance or presence of various diseases of the oncological and/or infectious type, as well as with the appearance or presence of inflammatory processes.

When D-dimer increases, thrombosis may occur

The appearance of high levels of D-dimer in pregnancy is caused by various situations:

• pathologies in fetal development;
• detachment of all or part of the placenta earlier than planned;
• multiple pregnancy;
• the presence of any damage, as well as their healing;
• rheumatoid diseases, ailments and diseases;
• infectious lesions;
• severe toxicosis;
• pre-stroke condition;
• diabetes mellitus, regardless of stage;
• venous thrombosis;
• disorders of the liver/kidneys or cardiovascular system;
• recent operations.

If during pregnancy, after several tests, a large jump in D-dimer levels was determined, this may indicate that blood clots have begun to appear in the woman’s body. As a result, it may be DIC syndrome or thromboembolism.

Reduced rate

It is very rare to observe a decrease in the normal level of D-dimer during pregnancy. Sometimes there are slight decreases in indicators, but they are so insignificant that they are practically ignored. However, if there is a decrease that draws attention to itself, the woman is urgently sent for a consultation with a hematologist. It is important to undergo appropriate treatment, since a low D-dimer level during pregnancy may indicate heavy bleeding during childbirth and pregnancy.

D-dimer and its norms in IVF

During artificial conception (i.e. in vitro fertilization), the first step is high-quality and long-term stimulation of the follicles and maintenance of the cyclic luteal phase.

During IVF, D-dimer monitoring will not be superfluous

In order to achieve this, the expectant mother is prescribed specialized drugs that have a direct effect on the parameters and levels of blood clotting. D-dimer in the case of IVF is greatly increased, so there is no norm here, as with natural fertilization. When studying D-dimer in the case of IVF, the doctor focuses, first of all, on the dynamics and marks of all parameters, indicators and levels of the coagulogram.

How are D-dimer results interpreted?

The final results of the analysis indicate the concentration level of the D-dimer indicator. Various laboratory organizations may use a specialized dimer-equivalent unit referred to as a DDU. Another specialized unit, fibrinogen equivalent, referred to as FEU, may also be used.

The unit of measurement is marked next to the numerical indicator, that is, in this case, it is ng/ml (or nanograms per milliliter). There may be other measurements, such as milligrams per liter or micrograms per liter (abbreviated mg/L and μg/L). The ratio of units of measurement is carried out according to the formula: 2 mg/l in FEU format is equal to 1 mg/l in DDU format.

Among other things, laboratories also have their own forms for displaying results, but almost every form has such a parameter as reference values. This parameter determines the norm of D-dimer during pregnancy.

It is important to remember: deciphering the results obtained is not a source of complete, detailed information about blood clotting indicators and the entire circulatory system. Therefore, in order to understand the degree and likelihood of a threat to the mother or to the unborn child, it is necessary to contact a qualified medical specialist for detailed advice.

Conclusion

The normal level for those who are “out of position” is 250 ng/ml. In pregnant women in the initial stages, the indicator may be the same, but it should increase in proportion to the duration of pregnancy.

D-dimer levels and identifiers can be affected by diseases of the internal organs, as well as infections or diabetes.

A decrease in D-dimer identifiers and levels is a rare phenomenon that poses a danger to the baby and the expectant mother.

A pregnant woman is very sensitive to everything related to her future baby. She tries to do everything that the doctor advises, follow the correct daily routine and diet, take the necessary tests and undergo the required examinations. Among them, much attention is paid to blood tests, and the study of d-dimer indicators during pregnancy in particular. This value makes it clear whether there is a risk of blood clots.

What does D-dimer mean?

D-dimers are commonly called particles of fibrin fibers, one of the blood components, the level of which may indicate the presence of blood clots. The mechanism of their appearance is as follows: soluble fibrin appears in the blood when the process of its coagulation occurs, which occurs with the direct participation of thrombins. When fibrin begins to dissolve, D-dimers appear, which can combine with the walls of blood vessels, thus causing their blockage. The life cycle of this breakdown product lasts only 6 hours.

Why are Di-dimer readings needed during pregnancy?

By testing the blood for the presence of this component, doctors can understand whether a woman is at risk of developing blood clots and how blood clots are treated. Also, D-dimer values ​​are important for coagulation studies.

Normal d-dimer level during pregnancy

During the period of bearing a child, the level of this indicator naturally increases. This phenomenon is due to the fact that global changes occur in a woman’s body, which also affect the processes of hemostasis and blood clotting. However, in medical practice there are no clearly predetermined norms for the D-dimer level during pregnancy. Thanks to medical practice, several conventional stages of increasing the data of this blood component have been identified, for example:

1. In the first trimester of pregnancy, the rate can increase by one and a half times.
2. The second trimester is characterized by a 2-fold increase.
3. In the final stages, the increase in d-dimer during pregnancy can be threefold when compared with the initial values.

What can be the consequences of elevated D-dimer during pregnancy?

In fact, positive deviations from such, even conditional, norms can negatively affect the overall progress of bearing a child. The expectant mother will be strongly recommended to do a comprehensive and thorough examination, since there is a risk of the occurrence or presence of preeclampsia and kidney disease. All these diseases may well indicate tissue damage or internal hematomas. As a rule, elevated D-dimer levels are characteristic of abnormal gestation, which may result in abruption of the placental organ or child.

What to do if d-dimer is elevated during pregnancy?

The most popular way to bring the indicator back to normal, characteristic of the current gestation period, is to take medications. Treatment takes place in a hospital setting, since medical supervision is simply necessary. As a rule, the medication course lasts no more than a week, during which the woman is prescribed injections, droppers and tablets. A drug such as Fraxiparine is administered locally, namely into the abdomen itself in the navel area. This allows the medication to quickly spread throughout the body and begin its effect. It is likely that the woman will also be prescribed droppers with Reopoglukin, which take quite a long time, but do not cause pain. Actovegin injections are also recommended to bring D-dimer levels back to normal during pregnancy.

When bleeding occurs, the body's defense processes are activated. Fibrin interacts with thrombin, clots appear, which leads to blood clotting.

D-dimer is a protein fragment that is formed when blood clots dissolve. The proteins of damaged vessels gradually begin to enter the active phase, binding to fibrin, which breaks down their particles to form a marker.

What is D-dimer and why is it important for pregnant women

The presence of high levels of the substance indicates that there is an overly active process of fibrinolysis, which appeared due to blood clotting and excessive accumulation of insoluble fibrin in previous stages.

During pregnancy, you will definitely have to take a test to identify deviations from the norm and monitor the condition of the body. Most often, in expectant mothers, the level of protein fragments increases, but it does not exceed the permissible values. Examining the patient's plasma, the doctor, finding an increased concentration of D-dimer, makes a conclusion about a violation of the hemostatic system. A significant increase in the marker affects the risk of blood clots.

Doctors believe that the main reasons for the increase in D-dimer content in the expectant mother during pregnancy are:

• kidney and liver diseases;
• diabetes mellitus;
• the appearance of late gestosis;
• dysfunction of the cardiovascular system;
• multiple pregnancy;
• infectious diseases;
• exacerbation of hemorrhoids;
• premature placental abruption;
• injuries or surgical interventions.

In what cases is a study prescribed?

Why do doctors refer a pregnant woman to determine the marker and is it necessary?

Let's look at the evidence in order:

1. The occurrence of deep vein thrombosis of the legs. It manifests itself as sharp, severe pain in the lower extremities, intensified when walking, and the inability to move normally. Swelling and blanching of the skin on the legs appears.
2. Pulmonary vascular pathology. Chest pain accompanied by a sharp, frequent, bloody cough and shortness of breath may be signs of pulmonary disease.
3. Multiple vascular thrombosis. Symptoms of a dangerous condition include bleeding gums, a bluish tint to the skin, scanty urination, nausea, vomiting, shortness of breath and pain in the abdomen and heart.
4. Late gestosis. It is characterized by the occurrence of edema, severe headaches, nausea, vomiting, high blood pressure and the detection of protein in the urine during pregnancy.
5. Placental abruption. A pregnant woman complains of pain in the lower abdomen, bleeding from the genital tract, and a “hard” abdomen. At the same time, symptoms of hypoxia appear in the child.

Important periods for controlling dedimer are 12, 22, 32 weeks. The price for identifying the marker is about 1200 rubles.

How to test for D-dimer

Venous blood is taken for the test. The test is carried out in the morning on an empty stomach, and the last meal should not be later than 8 hours before the expected test. Try to refrain from eating fatty, fried, spicy foods, carbonated or alcoholic drinks.

It is not recommended to smoke, or at least you should refrain from the bad habit 60 minutes before the test. You should not take medications the night before the test: this may affect blood clotting. Before taking the D-dimer test, try not to be nervous and eliminate physical stress.

What indicators are considered normal?

During pregnancy, an increased level of the marker is responsible for the expectant mother's predisposition to blood clotting pathology - thrombophilia. Low values ​​of D-dimer are rare, but with a pronounced decrease in protein fractions, the coagulological properties of the blood are disrupted, and there is a threat of massive bleeding during or after childbirth.

Depending on the laboratory where the test is performed, the units of measurement may be presented as μg/ml, mg/l, ng/l. Most often, preference is given to the latter designation.

To control the marker readings, the expectant mother can use a special table:

Please note that in twins, the concentration of the marker is increased compared to a singleton pregnancy.

First trimester

In the early stages, the expectant mother is tested for D-dimer along with a hemostasiogram - a comprehensive blood test for coagulation, so that the doctor can make a pregnancy prognosis.

In pregnant women, the level of the substance increases in the first weeks of gestation. There are no clear boundaries of the norm, since the concentration varies among different pregnant women. Low D-dimer levels are quite rare in expectant mothers. If its value has dropped, you should consult a hematologist. The doctor is much more attracted to d-dimer levels that are higher than normal.

If the indicators are significantly exceeded, the specialist conducts a thorough examination, since most pregnancies occur with a pathological course. Normal values ​​of protein fragments are considered to be values ​​increased by 1.5 times compared to their concentration outside of gestation. The D-dimer level should not exceed 750 ng/ml.

Second trimester

The marker levels continue to increase, exceeding the pre-gestation norm by 2 times. Its upper threshold should not be more than 1000 ng/ml. Then the doctor boldly concludes that the expectant mother has no risk of thrombosis.

If the D-dimer is significantly elevated, beyond the specified level, the doctor prescribes the woman anticoagulation therapy.

Third trimester

With the onset of the 3rd trimester, the concentration of D-dimer should gradually increase, but the levels do not exceed 1500 ng/ml. Don't worry: this is completely normal. Sometimes in expectant mothers the marker rises to 2000-2500 ng/ml or even reaches 6000 ng/ml.

If the level of protein fractions significantly exceeds the specified values, an analysis is performed for RFMK - a coagulogram parameter that reflects the appearance of an excess amount of blood clots in the circulating blood. The indicator indicates the development of DIC syndrome, which is a very dangerous condition for the life of the child and the expectant mother.

It happens that at the beginning of gestation the marker values ​​were within the normal range, but at the end they begin to increase. Every organism of a future mother is individual; biochemical processes occur according to their own schedule. The blood coagulation system is activated during any period of gestation. How dangerous this is can only be judged by a specialist.

What to do if your D-dimer is high or low - your doctor advises

When a doctor diagnoses a woman with an excess of normal d-dimer values, but her overall health does not suffer at all, treatment is carried out on an outpatient basis with a visit to a day hospital. If the expectant mother complains of swelling, pain in the legs, or if she has high blood pressure or protein in her urine, treatment is prescribed in a hospital setting.

Drugs used to control blood clots:

1. Low molecular weight heparin– Fraxiparine, Clexane. The anticoagulant is available in the form of an injection solution and has the property of thinning the blood. The injection is placed in the umbilical area without causing severe pain: there may be a slight burning or tingling sensation at the injection site, which goes away 10-20 minutes after the procedure.
2. Medicines to increase blood volume- Reopoliglyukin. The doctor prescribes the drug for manifestations of thrombosis or a tendency to thromboembolism. It helps dissolve blood clots, promoting free blood circulation through the vessels. A pregnant woman is given droppers with a solution.
3. Medicines that improve uterine blood flow– Actovegin, Kurantil.

In addition to drug therapy, you will have to drink a lot of fluid to naturally thin the blood and prevent the formation of blood clots. As for traditional methods, doctors recommend using them together with drug treatment and only after consulting a doctor.

If D-dimer levels have decreased, specialists may not pay much attention to this value. A slight decrease in the marker during pregnancy does not require additional examination and treatment. If the expectant mother has protein fractions below 500 ng/ml, there is a risk of problems during childbirth or the postpartum period. Then the specialist prescribes a consultation with a hematologist and carries out a thorough examination and treatment.

Prevention measures

The rules are simple but effective:

1. Drinking large amounts of fluid: to naturally thin the blood and prevent blood clots.
2. Performing physical therapy designed specifically for pregnant women, or doing yoga or aqua aerobics.
3. Walking in the fresh air.
4. Proper distribution of work and rest.
5. Reducing the consumption of fatty foods, baked goods and sweets.
6. Adding the required amount of vegetables and fruits to the diet.
7. Get a healthy night's sleep at least 8 hours a day.
8. Regular visits to your doctor to undergo the necessary tests and examinations.

At the stage of pregnancy planning, a consultation with a geneticist will be required if the woman has close relatives with abnormalities in the functioning of the hemostatic system or had previous frozen pregnancies at an early stage (8-9 weeks of gestation). These expectant mothers have an increased risk of thrombosis. Early diagnosis of high marker values ​​will eliminate the threat of complications during or after childbirth.

Experts say that the best prevention of problems during pregnancy is proper planning. Doctors recommend drinking a herbal complex based on Altai herbs in advance for easy conception and successful pregnancy - Seraphim's Gathering. The product has a minimum of contraindications, gently prepares the body for changes in status, and cures old chronic infections.

Dr. Berezovskaya talks about tests during pregnancy:

Conclusion

The main function of blood is to carry oxygen, nutrients and hormones to the organs, so in case of any abnormalities it should be examined, especially during gestation.

One of the most important indicators is D-dimer, which may not correspond to normal values ​​during pregnancy. Don’t panic: this happens and is not always a threat to the baby’s health or the course of pregnancy. With a pronounced increase in the marker, there is an excessive tendency to form blood clots, which forces the doctor to prescribe drugs that reduce blood clotting activity.

You may have never heard of a test called D-dimer before becoming pregnant. But when you are expecting a baby, such an analysis is mandatory. The level of D-dimer during pregnancy will allow you to determine in advance the level of susceptibility to thrombosis. In this case, if necessary, doctors will have time to slightly adjust the blood clotting of a pregnant woman.

It is worth noting that if the level of D-dimer does not fully correspond to the week of pregnancy, this does not mean that there are disorders or risks in the woman’s body.

When a hemorrhage occurs in the human body for some reason, a special substance, fibrin, comes into play. With its help, the blood becomes thicker, and a blood clot gradually forms. Fibrin helps stop bleeding. After some time, the clot should disappear so that the blood can again circulate without hindrance through human vessels.

When the blood clot begins to dissolve, a certain amount of D-dimer enters the blood. This is one of the constituent parts of fibrin fibers. It is in this case that we can say that there is a possibility that the level of blood clots in the body is too high. D-dimer is present in the body of any person, but during pregnancy, under the influence of hormonal changes, its level can increase significantly. When a woman is pregnant, the amount of a hormone called estrogen increases. It is this that causes too high activity of fibrin and, accordingly, D-dimer. Increased levels of D-dimer during pregnancy can provoke the formation of blood clots directly in the uterus. This will immediately affect the condition of the fetus and can cause prolonged oxygen starvation, the development of diabetes mellitus in the mother or varicose veins.

In order to avoid such unpleasant diseases and not harm the baby, you need to regularly monitor the level of D-dimer in the blood throughout pregnancy. The analysis is carried out exclusively on an empty stomach. Before donating blood, a pregnant woman should not eat for about 12 hours. She can drink exclusively pure water, but in small quantities. For analysis, blood must be taken from a vein.

Pregnancy D-dimer norm table

The normal level of D-dimer in the human body is quite low. It is approximately 400-500 ng/ml. But when a woman is expecting a child, the situation completely changes. All internal organs are rebuilt. The hemostatic system was no exception. To be more precise, it is not rebuilt, but activated. The longer the pregnancy, the faster all blood clotting processes occur. In this way, the pregnant woman’s body is actively preparing for labor, so that during childbirth the loss of a large amount of blood can be avoided. D-dimer levels during pregnancy will always be slightly higher than normal. A variety of factors can also affect its level.

Blood clots can appear as a result of a variety of diseases that exist in the female body. Pregnant women are at risk due to the activation of the entire hemostatic system.

Indications for additional testing for D-dimer levels during pregnancy may include:

• presence of venous thrombosis;
• there is a severe form of toxicosis;
• a woman has diabetes;
• presence of DIC syndrome (disseminated intravascular coagulation syndrome);
• problems with the pulmonary artery - thromboembolism;
• stroke.

All these diseases lead to the activation of the process of blood clots in the body.

During pregnancy, the number of factors that can increase D-dimer levels in the blood increases significantly.

An increase in D-dimer during pregnancy can be caused by the following factors:

• increased bilirubin levels;
• injuries;
• the presence of infections in the body;
• problems with heart function;
• the level of D-dimer during multiple pregnancy increases several times;
• placental abruption ahead of schedule;
• rheumatic diseases;
• high levels of lipids in the body;
• operational interventions;
• education related to oncology.

First trimester of pregnancy: D-dimer norm

Medicine does not have clear standards for the level of D-dimer in the blood during pregnancy. Each laboratory may have its own accepted standards. These are the ones you need to focus on when you take the test. It is worth paying attention to the fact that the level of D-dimer during pregnancy can be measured not only ng/ml, but also μg/ml or mg/l.

Clear boundaries of norms are not established for another reason: the determination of this particular marker in the blood of a pregnant woman cannot be considered diagnostic. Different women have completely different D-dimer levels, even if they are at the same gestational age. For one woman, a certain indicator may threaten her child, for another it will be the norm. But if the increase in D-dimer during pregnancy is too strong, then this means that a more thorough examination should be immediately carried out. In many cases, when the level of the substance is too high, doctors after examination find numerous pathologies.

D-dimer during pregnancy can only mean something when it is combined with a hemostasiogram - a special test that determines the level of blood clotting. Only a specialist can draw certain conclusions based on the results of the tests, taking into account the state of health of the expectant mother, her individual characteristics of the body, the duration of pregnancy and many other examinations and circumstances.

If, after taking the test, you were told that the level of D-dimer during pregnancy in the first trimester is a little high, you should not worry ahead of time. This phenomenon occurs quite often. In some cases, the level of the substance begins to increase slightly from the first month of pregnancy. In the first trimester, the D-dimer norm is 500 ng/ml and above. In most cases, the marker level can rise one and a half times, reaching 750 ng/ml.

A decrease in D-dimer during pregnancy is extremely rare. But even if this happened, this does not cause alarm to the doctor. Only a high level of this marker can harm a pregnant woman and her child. If the indicator is too low in relation to the norm, then you cannot do without consulting a hematologist. This indicates that there are certain problems or disorders in the blood coagulation system. This can lead to very heavy bleeding during labor or some time after birth.

Second trimester of pregnancy: normal D-dimer levels

The marker indicator continues to increase. In some cases, blood levels of the drug may be double what they were before pregnancy. The maximum level in the second trimester is considered to be 900 ng/ml. If the tests show a significant excess of the norm, then additional examinations must be carried out. In some cases, it is impossible to do without therapy with special anticoagulant drugs. The doctor prescribes them when the level of D-dimer during pregnancy increases sharply compared to previous tests. This often occurs in the second trimester. The expectant mother is placed in a hospital so that full treatment can be carried out.

Normal D-dimer levels in the third trimester of pregnancy

The concentration of D-dimer continues to increase and by the end of pregnancy it will exceed the “pre-pregnancy” level by approximately three times. The norm in this case is already 1500 ng/ml. This phenomenon is quite normal, so there is no need to worry.

During pregnancy, the level of D-dimer can often exceed the established limits, but the analysis itself cannot be called informative. You should not consider such an analysis very important, but if the gynecologist leading your pregnancy recommends corrective therapy, do not refuse. Follow all doctor's orders, because the condition can worsen sharply, which will lead to a threat to the baby's life.

D-dimer level during pregnancy: IVF

Taking oral contraceptives can provoke a high marker level. Since shortly before in vitro fertilization the woman’s ovaries are stimulated with the help of hormones, the activation of hemostasis can occur much more actively than in the case of natural fertilization. The risk of increasing D-dimer in the blood increases several times. In this regard, during IVF it is necessary to constantly check the level of the substance. The first test is taken a few days after the embryos are placed in the woman’s uterine cavity.

The test, as in all other cases, must be done on an empty stomach. Blood is taken exclusively from a vein. In most cases, the analysis results will be ready within 24 hours.

High marker level: decoding D-dimer during pregnancy

When the marker value is too high, this means that active blood clot formation is occurring in the pregnant woman’s body. It may also be a sign of various diseases or pathologies that are directly related to the hemostatic system. The main ones include the following:

1. DIC syndrome;
2. thromboembolism;
3. thrombophilia, which is transmitted exclusively at the genetic level.

When a woman regularly takes this test during pregnancy and the next result shows too sharp a jump, this becomes a signal that blood clots are forming in the body. Only a specialist in this field can decipher D-dimer during pregnancy and prescribe further examinations if necessary.

Treatment for high D-dimer levels

If the analysis shows increased D-dimer values ​​during pregnancy, then the woman is immediately sent to the hospital, where she must undergo a course of therapy.

To treat the problem, the following drugs are usually used:

1. Fraxiparine. The drug acts as a direct anticoagulant. The drug is injected exclusively subcutaneously into the thigh area or into the abdomen near the navel. The course of treatment with Fraxiparine is seven days. At the same time, doctors constantly monitor changes in the results obtained.
2. Reopoliglyukin. The drug must be administered intravenously using a dropper. In order to significantly improve blood flow in the placenta, a solution of Curantil or Actovegin can be additionally administered.

The level of D-dimer during pregnancy must be monitored in order to promptly determine the presence of pathologies associated with blood clotting. This will allow you to avoid many complications in the future with the woman’s health, the development of the child, as well as directly during childbirth.