C0315 Comparison of different D-dimer assays in normal pregnancy

Abstract

Background: Normal pregnancy is associated with hypercoagulation state and activation of fibrinolysis. D-dimer is an important test of activation of haemostasis. D-dimer concentration progressively increases during normal pregnancy. It is important to establish normal deviations of D-dimer for physiological pregnancy with different assays. Methods: The citrate plasmas of 117 healthy pregnant women at the age of 19 till 40 yearswere evaluated. D-dimer levels weremeasured by ELISA (“Asserachrom D-DI”, Diagnostica Stago, France), quantitative immunoturbidimetric latex agglutination assay (“Auto Blue D-dimer 400”, England) and semi quantitative latex agglutination assay (“DDimer Test”, Diagnostica Stago, Roche, France). STATISTICA 6.0 was used. Results are given as median (Me) with 95% confidence intervals (CI) for each gestational period. A Pb0.05 was considered statistically significant. Results: Results of the ELISA-method were increased both between I and II trimesters (172.45-1109.75 ng/ml FEU vs 244.40-1268.00 ng/ml FEU respectively; pb0.01) and II and III trimesters (244.40-1268.00 ng/ ml FEU vs 512.25-1891.50 ng/ml FEU respectively; pb0.01). Parameters of the quantitative immunoturbidimetric latex agglutination assay were significantly high between I and II trimesters (6.90-468.55 ng/ml vs 57.00-1434.50 ng/ml) only. The results of the latex testwere reported in three categories: normal (b500 ng/ml FEU), positive (500-3000 ng/ml FEU) and over positive (N3000 ng/ml FEU). High D-dimer level was in 68.2% of pregnant women even in I trimester. In II and III trimesters positive and over positive results were increased to 82.4% and 90.9% respectively whereas normal results were 17.6% and 9.1% respectively. Comment: It is recommended that D-dimer be estimated by themost informative ELISA. This quantitative assay adequately evaluates D-dimer level in each trimester of pregnancy.