D-dimer Concentrations in Women with Uncomplicated Miscarriage and Intrauterine Fetal Death: A Prospective Study
Keywords:
intrauterine fetal death, miscarriage, coagulopathy, clotting tests.Abstract
The use of D-dimer in identifying women at increased risk of thrombosis/ hemorrhage in pregnancy is understudied. This study aimed to determine the prevalence of coagulation disorders in women with uncomplicated miscarriages and intrauterine fetal death (IUFD) by using the D-dimer concentration and to examine its association with gestational age using curve estimation. Fifty women were diagnosed with fetal death during the study period. Of these, 22cases (44%) were IUFD ? 22 weeks, and 28 cases (56%) miscarriage had no pregnancy-associated complications. Both groups were similar in age, prior miscarriage, parity, hemoglobin, red blood cell indices and duration of fetal death p>0.05. No significant differences were observed in PT, aPTT, INR, platelet counts, or fibrinogen p >0.05.
The IUFD group had significantly elevated concentrations of FDP and D-dimer (p=0.037), compared to miscarriage group. Also, the study showed 9.1% of IUFD group and 3.6% of miscarriage group at risk of devolving thrombosis. Also, 18.4% of women with IUFD had low platelet counts (counts < 150x109) versus none in the miscarriage group, p=0.019. There was no association between gestational age and D-dimer in both miscarriage and IUFD cases.
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