Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Thromb Res. 2011 Oct;128(4):e33-8. doi: 10.1016/j.thromres.2011.05.011. Epub 2011 Jun 8.
To determine how the D-dimer level changes after cesarean section, a topic that has not been studied extensively.
The D-dimer level (μg/mL) was measured in 792 and 119 women with singleton and twin pregnancies, respectively, on the day or one day before cesarean section and on postpartum days 1, 3, and 7. None of the women developed venous thromboembolism with clinical symptoms. The data for other two women who underwent a cesarean section and developed pulmonary thromboembolism on postpartum days 0 to 1 were also presented.
The preoperative D-dimer level (median, μg/mL) of 2.4 increased on postpartum day 1 to 6.0, then decreased to 2.8 on postpartum day 3, and again increased to 4.5 on postpartum day 7 in the singleton pregnancies. A similar pattern, but with slightly higher values, was seen in the twin pregnancies. The 95 percentile value of D-dimer for singleton and twin pregnancies was 6.9 and 10.5 on days -1/0, 19.7 and 25.7 on day 1, 9.7 and 13.5 on day 3, and 15.7 and 17.7 on day 7, respectively. The D-dimer level after pulmonary thromboembolism was greater than the 99 percentile value and the 98 percentile value in the two women, respectively.
Our data regarding the D-dimer level may be helpful when considering the normal range of D-dimer for postpartum women with cesarean delivery.
确定剖宫产术后 D-二聚体水平的变化情况，这是一个尚未得到广泛研究的课题。
分别测量了 792 名和 119 名单胎和双胎妊娠妇女在剖宫产术前一天或当天以及产后第 1、3 和 7 天的 D-二聚体（μg/mL）水平。所有妇女均无临床症状的静脉血栓栓塞。还报告了另外两名在产后第 0 至 1 天接受剖宫产并发生肺血栓栓塞的妇女的数据。
2.4μg/mL 的术前 D-二聚体水平在产后第 1 天增加至 6.0μg/mL，然后在产后第 3 天降至 2.8μg/mL，在产后第 7 天再次增加至 4.5μg/mL。在双胎妊娠中，也观察到类似的模式，但数值略高。D-二聚体的 95%百分位数在单胎和双胎妊娠中，术前-1/0 天为 6.9 和 10.5，第 1 天为 19.7 和 25.7，第 3 天为 9.7 和 13.5，第 7 天为 15.7 和 17.7。两名妇女的肺血栓栓塞后 D-二聚体水平均高于 99%分位数和 98%分位数。
我们关于 D-二聚体水平的数据在考虑行剖宫产术的产后妇女的 D-二聚体正常范围时可能会有所帮助。
