The clinical significance of D-dimer concentrations predicting the risk of venous thromboembolism in patients with hyperemesis gravidarum.

OBJECTIVE

The aim of this prospective cross-sectional study was to determine serum D-dimer and fibrinogen concentrations in pregnant women with hyperemesis gravidarum and compare them with those of healthy pregnant women.

METHODS

The study group consisted of 50 patients diagnosed with hyperemesis gravidarum. The control group consisted of 50 healthy pregnant women. Maternal characteristics such as age, gestational age, body mass index, gravida, and parity were recorded. Following a 12-h fasting period, venous blood samples of 10 cc were collected. The blood samples were centrifuged, and serum was stored at -80°C until assay. Blood count, coagulation profiles, and biochemical analyses were performed, and the results were analyzed using appropriate statistical tests.

RESULTS

The data of 45 patients in the hyperemesis gravidarum group and 47 patients in the control group were analyzed. Serum levels of hemoglobin, white blood cell and platelet counts, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, and international normalized ratio were similar between groups (p>0.05). There was a positive association between serum D-dimer levels and serum fibrinogen levels (p=0.039, r=0.215). Also, a positive association was observed between serum D-dimer levels with the degree of ketonuria (p=0.008, r=0.274) and the number of vomitings per day (p=0.02, r=0.346) in hyperemesis gravidarum patients.

CONCLUSION

Serum D-dimer levels were not different in patients with hyperemesis gravidarum versus healthy women during the first trimester of pregnancy. Pregnant women tend to have higher D-dimer concentrations as hyperemesis gravidarum severity increases. Serum D-dimer levels cannot be used for the evaluation of potential venous thromboembolism in patients diagnosed with hyperemesis gravidarum.