An Increased Plasma D-Dimer Levels During Different Stages of Normal and Complicated Pregnancies Among Women in Bisha, Saudi Arabia.

INTRODUCTION

Hypercoagulability is one of the most reported state among Pregnant women. During pregnancy, the concentrations of D-dimer increase in a trimester-dependent- manner. The presence of gestational diabetes (GD) and gestational hypertension (GH) lead to further elevation in D-dimer levels. Pregnant women are at an increased risk of developing Venous thromboembolism (VTE), which can be fatal for both the mother and fetus. Elevated D-dimer levels during pregnancy could result in misdiagnosing other thrombotic diseases, emphasizing the need for further confirmatory testing for VTE. It is crucial to observe the plasma D-dimer concentrations among pregnant women at maternity and children's hospitals as it plays a role in guiding the anticoagulant treatments and minimizing the incidence of VTE among pregnant women.

AIM

The main objective of the current study was to detect the changes in the plasma D-dimer concentrations in healthy and complicated pregnancies across different gestational trimesters among women at the Maternity and Children's Hospital, Bisha, Saudi Arabia.

METHODS

A cross-sectional study was conducted from March 2022 to March 2023, involving the analysis of plasma samples collected from 230 pregnant and non-pregnant women. Three samples were collected from each subject in each trimester. D-dimer measurement was conducted using an ACL Elite Pro Automated analyzer.

RESULTS

The findings of this study show that D-dimer levels increased progressively throughout the pregnancy trimesters across all study groups. The increase was more noticeable among women with gestational diabetes (278.39 ± 29.808 ng/mL) and gestational hypertension (320.63 ± 12.157 ng/mL), suggesting that these complications influence D-dimer levels more significantly than healthy and multiple pregnancies. Notably, a positive correlation was found between age and D-dimer levels across all groups (p < 0.05), with the highest mean levels in the 41-48 age group.

CONCLUSION

D-dimer levels rise progressively throughout pregnancy and are significantly elevated in women with gestational diabetes and hypertension. These findings underscore the importance of interpreting D-dimer values in the context of gestational age and pregnancy complications. Additionally, maternal age influences D-dimer concentrations, emphasizing the need to interpret results within the context of age-related physiological changes during pregnancy.