Fibrin monomer in laboratory assessment of the hypercoagulable state during pregnancy: 616-005.6:618.177-089.888.11:618.3-06

Abstract

Summary. Background. Pregnancy-associated episodes of venous thromboembolic complications (VTEC) are one of the leading causes of maternal mortality and general decline in quality of life. Searching for laboratory markers that can provide reliable information about blood coagulation state in pregnancy continues. Objectives: to determine the significance of laboratory measurement of D-dimer and fibrin monomer concentrations in pregnant women with risk of VTEC development. Patients/Methods. The retrospective-prospective observational study included 171 women which were categorized into 3 groups: group I — 69 infer- tile patients receiving assisted reproductive technologies at the stage after embryo transfer into uterus; group II — 49 pregnant women (20–40 week of gestation) with preeclampsia of varying severity; group III — control group consisted of 53 somatically healthy pregnant women with physiological uncomplicated pregnancy in the first (n=49) and second (n=4) trimester of gesta- tion. Fibrin monomer and D-dimer were measured by immunoturbidimetry in all women. Results. The levels of fibrin monomer and D-dimer in group II were significantly elevated compared with groups I and III. Statistically significant correlation of medium strength between fibrin monomer and D-dimer concentrations was revealed in group II (ρ=0.482; p<0.05) and also noted that the fibrin monomer level exceeded the reference range in 12.2% of cases whereas only half of this cases was accompanied by increased D-dimer concentration above the reference values for the corresponding gestational age. Conclusions. Measurement of fibrin monomer concentration provides information about the activation of blood coagulation “here and now”. Pregnant women with a significant increasing of fibrin monomer level are the group for active monitoring and additional VTEC risk stratification.

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