The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Changes of D dimer in women with gestational diabetes and healthy women after elective cesarean section

Document Type : Original Article

Authors
Fatemeh Mallah 1
Mina Zeinalzadeh 2
Dara Alvandfar 3
1 Associate Professor, Department of Gynecology Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 B.Sc. student of Anesthesia, School of Paramedical, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Assistant Professor, Department of General and Vascular Surgery, Comfortable Breathing and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
10.22038/ijogi.2021.19383
Abstract
Introduction: Due to the increasing prevalence of gestational diabetes, which is one of the indications for cesarean section, and both of these cases have adverse effects on the coagulation pathway, this study was performed with aim to compare the level of D-dimer in two groups of healthy and diabetic pregnant women after cesarean section to assess the coagulation risks after cesarean section.
Methods: This descriptive study was performed in 2019 on 150 healthy and gestational diabetes women who were candidates for elective cesarean section in 2019. The level of D-dimer was measured on the day before surgery, the day after surgery, on the seventh and fourteenth days for both groups. Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, regression and Spearman correlation tests. P<0.05 was considered statistically significant.
Results: The level of D-dimer on the day after surgery had the most statistically significant difference between healthy and gestational diabetes women (P=0.001). Also, on seven days after surgery (P=0.012) and 14 days after surgery (P=0.039), the amount of D-dimer was significantly higher in women with gestational diabetes than healthy women. It was also found that smoking (P=0.031) and previous history of pregnancy (P=0.041) were significantly associated with increased D-dimer levels in women with gestational diabetes.
Conclusion: Gestational diabetes plays a role in increasing the level of D-dimer and can lead to an increase in plasma level of D-dimer.
Keywords
Cesarean section
D-dimer
Gestational diabetes
Deep vein thrombosis
  1. Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thrombosis and haemostasis 2020; 120(05):876-8.
  2. Kearon C, de Wit K, Parpia S, Schulman S, Afilalo M, Hirsch A, et al. Diagnosis of pulmonary embolism with d-dimer adjusted to clinical probability. New England Journal of Medicine 2019; 381(22):2125-34.
  3. Gutiérrez García I, Pérez Cañadas P, Martínez Uriarte J, García Izquierdo O, Angeles Jódar Pérez M, García de Guadiana Romualdo L. D-dimer during pregnancy: establishing trimester-specific reference intervals. Scandinavian journal of clinical and laboratory investigation 2018; 78(6):439-42.
  4. Aghamohamadi D, Gol MK. An investigation into the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective cesarean section: A double-blind clinical trial. International Journal of Women's Health and Reproduction Sciences 2019; 7(4):520-5.
  5. Rafiei M, Ghare MS, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. International Journal of Reproductive BioMedicine 2018; 16(4):221.
  6. Grossman KB, Arya R, Peixoto AB, Akolekar R, Staboulidou I, Nicolaides KH. Maternal and pregnancy characteristics affect plasma fibrin monomer complexes and D-dimer reference ranges for venous thromboembolism in pregnancy. American journal of obstetrics and gynecology 2016; 215(4):466-e1.
  7. Durazzo M, Ferro A, Gruden G. Gastrointestinal microbiota and type 1 diabetes mellitus: the state of art. Journal of clinical medicine 2019; 8(11):1843.
  8. Lu DY, Huang CC, Huang PH, Chung CM, Lin SJ, Chen JW, et al. Metformin use in patients with type 2 diabetes mellitus is associated with reduced risk of deep vein thrombosis: a non-randomized, pair-matched cohort study. BMC cardiovascular disorders 2014; 14(1):1-7.
  9. Baboolall U, Zha Y, Gong X, Deng DR, Qiao F, Liu H. Variations of plasma D-dimer level at various points of normal pregnancy and its trends in complicated pregnancies: a retrospective observational cohort study. Medicine 2019; 98(23).
  10. Eghdam-Zamiri R, Khanbabayi Gol M. Effects of ginger capsule on treatment of nausea and vomiting in patients receiving cisplatin undergoing mastectomy: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2020; 22(11):15-21.
  11. Alvandfar D, Alizadeh M, Khanbabayi Gol M. Prevalence of pregnancy varicose and its effective factors in women referred to gynecology hospitals in Tabriz. Iran J Obstet Gynecol Infertil 2019; 22(9):1-7.
  12. Fakhari S, Bile Jani I, Atashkhouei S, Khanbabayi Gol M, Soliemanzadeh S. Comparing the effect of hypotension treatment due to spinal anesthesia with ephedrine or phenylephrine on arterial blood gases and neonatal Apgar score during cesarean delivery in obese mothers: randomized clinical trial. Iran J Obstet Gynecol Infertil 2019; 22(10):12-20.
  13. Manafi A, Zakeri H, Salahyan F, Tavassoli M, Shekoohi F, Kokabi R, et al. Blood Glucose Alterations in Spinal versus General anesthesia in those undergoing Cesarean Section Delivery. Journal of Fasa University of Medical Sciences 2015; 5(1):44-50.
  14. Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141(2):e691S-736S.
  15. Zaini R, Al-Rehaili A, Kufia R. Evaluation of plasma D-dimer concentration among normal and complicated pregnancies, Saudi Arabia. International Journal of Women’s Health and Reproduction Sciences 2019; 7(1):17-23.
  16. Hu W, Wang Y, Li J, Huang J, Pu Y, Jiang Y, et al. The predictive value of D-dimer test for venous thromboembolism during puerperium: a prospective cohort study. Clinical and Applied Thrombosis/Hemostasis 2020; 26:1076029620901786.
  17. Siennicka A, Kłysz M, Chełstowski K, Tabaczniuk A, Marcinowska Z, Tarnowska P, et al. Reference Values of D-Dimers and Fibrinogen in the Course of Physiological Pregnancy: the Potential Impact of Selected Risk Factors—A Pilot Study. BioMed Research International 2020; 2020.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 10
November 2021
Pages 1-7