Relationship between prenatal D-dimer level and postpartum hemorrhage in patients with preeclampsia / 中国医师杂志

ABSTRACT

Objective:To investigate the relationship between prenatal D-dimer level and preeclampsia complicated with postpartum hemorrhage (PPH).Methods:The clinical data of 340 preeclampsia pregnant women in Hechi People′s Hospital from January 2016 to December 2020 were retrospectively analyzed. According to whether PPH occurred, they were divided into preeclampsia complicated with PPH group (PPH group, 57 cases) and uncomplicated PPH group(non PPH group, 283 cases). The general clinical data, blood routine and coagulation function parameters before delivery of the two groups were analyzed, and the differences between the two groups were compared. Logistic regression analysis was used to investigate the relationship between prenatal D-dimer level and preeclampsia complicated with PPH. Meanwhile, the influence of D-dimer level on the occurrence of PPH in preeclampsia patients was quantified. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of D-dimer level on preeclampsia complicated with PPH.Results:Compared with non-PPH group, PPH group had higher white blood cell counting and D-dimer levels ( P<0.05), and lower levels of platelet count and fibrinogen (all P<0.05); there were no significant difference in the levels of hemoglobin and activated partial thrombin time (APTT) between the two groups (all P>0.05). Multivariate logistic regression analysis showed that elevated D-dimer level was an independent risk factor for PPH in preeclampsia patients ( OR=1.150, 95% CI 1.076-1.230, P<0.001). When D-dimer≥2.16 μg/ml, the risk of PPH in preeclampsia patients increased by 2.804 times ( OR=3.904, 95% CI 1.705-8.939, P=0.001). In patients who delivered three times or more, D-dimer predicted the occurrence of PPH with an AUC of 0.851, specificity of 60.78%, and sensitivity of 100%. Conclusions:Elevate D-dimer level is an independent risk factor for preeclampsia complicated with PPH. When the D-dimer level increased by 1 unit, the risk of PPH in preeclampsia patients increased by 0.15 times. D-dimer has a high predictive value for the occurrence of PPH in preeclampsia patients who delivered three times or more.