Changes in Fibrinogen and D-Dimer During Complicated and Uncomplicated Pregnancy.

Chen Gong, Hai Jiang, Yang Su, Jing Yang, Yuan Wei, Rui Qiao, Yangyu Zhao
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Abstract

Introduction: The increase in fibrinogen levels is vital for the formation of a prothrombotic state during gestation to counter-bleeding challenges at delivery. However, pregnancy complications characterized by systemic inflammatory response syndrome may consume fibrinogen, resulting in elevated D-dimer levels.

Methods: Our study is based on a total of 16 768 pregnant women who delivered between December 1, 2013, and December 1, 2018, to study fibrinogen and D-dimer changes during gestation under normal and multiples of pathogenic states.

Result: Compared with nonpregnant women (3.04[3.02-3.08]), pregnant women depicted higher fibrinogen levels throughout gestation (p < 0.001). In the uncomplicated group, fibrinogen levels increased throughout the first (3.28[3.26-3.29]), second (4.04[4.01-4.07]), and third trimesters (4.40[4.38-4.41]) but dropped at delivery (4.30[4.28-4.31]), similar to the changing pattern of the pregnancy-related complication group and pre-existing disorder group. Women with pregnancy-related complications showed significantly higher mean fibrinogen levels throughout gestation (p < 0.001), except for placental abruption, where, it decreased from the third trimester and was lower than that of uncomplicated pregnancies (3.89[3.60-4.17] vs. 4.40 [4.38-4.41], p = 0.001). Among uncomplicated pregnancies, D-dimer grew rapidly throughout the first trimester (0.09[0.06-0.15]), second trimester (0.28[0.19-0.40]), third trimester (0.51[0.36-0.78]), and delivery (0.70[0.47-1.03]).

Conclusion: Women with pregnancy-related complications and pre-existing disorders shared similar changing patterns; however, the D-dimer of women with placenta accreta presented higher levels than those with uncomplicated pregnancies since the first trimester. We concluded that fibrinogen levels are expected to increase steadily, but in patients with placental abruption, fibrinogen levels dropped during the third trimester. D-dimer levels typically rise consistently throughout pregnancy, yet in patients with placenta accreta, they show abnormal elevation since an early stage of pregnancy.

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并发症和非并发症妊娠期间纤维蛋白原和 D-二聚体的变化。
导言:纤维蛋白原水平的升高对于在妊娠期形成促血栓形成状态以应对分娩时的出血挑战至关重要。然而,以全身炎症反应综合征为特征的妊娠并发症可能会消耗纤维蛋白原,导致 D-二聚体水平升高:我们的研究以2013年12月1日至2018年12月1日期间分娩的16 768名孕妇为研究对象,研究正常和多重致病状态下妊娠期纤维蛋白原和D-二聚体的变化:与非妊娠妇女(3.04[3.02-3.08])相比,妊娠妇女在整个妊娠期的纤维蛋白原水平较高(p 结论:妊娠妇女的纤维蛋白原水平在整个妊娠期都较高:与妊娠相关的并发症和原有疾病的妇女具有相似的变化模式;然而,与无并发症妊娠的妇女相比,胎盘早剥妇女的 D-二聚体水平自妊娠头三个月起就较高。我们的结论是,纤维蛋白原水平预计会稳步上升,但在胎盘早剥患者中,纤维蛋白原水平在妊娠三个月期间会下降。D-二聚体水平通常在整个孕期持续上升,但在胎盘早剥患者中,D-二聚体水平从妊娠早期就开始异常升高。
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