Introduction: The differences in the D-dimer rise between women with singleton and multifetal pregnancies have not been studied extensively. Materials and Methods: D-Dimer levels were determined in 1089 blood specimens from 1089 women in various stages of pregnancy, including 977 and 112 women with singleton and multifetal pregnancies, respectively. None of the 1089 women developed hypertension or clinical venous thromboembolism during pregnancy or in the postpartum period. Results: The D-dimer levels were significantly and positively correlated with gestational week at examination in women with singleton or multifetal pregnancies. The D-dimer levels (mu g/ml, mean +/- SD [number of specimens]) determined at the 1st trimester did not differ significantly (0.81 +/- 0.82 [102] for singleton vs. 1.20 +/- 0.77 [7] for multifetal), but those at the 2nd (1.61 +/- 1.45 [216] vs. 2.62 +/- 2.26 [59]) and 3rd (2.37 +/- 2.22 [659] vs. 4.02 +/- 2.14 [46]) trimesters were significantly higher in women with multifetal than singleton pregnancies. The 90th percentile value was 4.31 mu g/ml for 1089 specimens. A significantly greater number of women exceeded 4.31 mu g/ml during the 2nd (16.9% vs. 5.6%, P = 0.0043) and 3rd (34.8% vs. 10.6%, P < 0.0001) trimesters among those with multifetal than with singleton pregnancies. Conclusions: The degree of D-dimer rise in pregnancy was greater in women with multifetal than with singleton pregnancies. (C) 2013 Elsevier Ltd. All rights reserved
antithrombin escapes from the blood into the interstitial space in pregnant women. This phenomenon partially explains the gradual decline in antithrombin activity observed in these six pregnant women with generalized edema and large volumes of ascites.
A 35-year-old Japanese nulliparous woman exhibited rapid weight gain (6 kg/7 days), reduced antithrombin activity and platelet count at 37 weeks of gestation without hypertension or proteinuria, and underwent cesarean section. Postnatally, pulmonary edema developed for 7 days, with transient hypertension and proteinuria, and bodyweight loss (14.6 kg) by 14 days postpartum. Platelet count and antithrombin activity normalized promptly postpartum. Despite a life-threatening clinical condition due to enhanced vascular permeability, neither hypertension nor proteinuria appeared antenatally. Determining antithrombin activity and platelet count may be useful for distinguishing between women with pathological edema and physiological edema.
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