Maternal serum-d-dimer levels in prediction of preterm labour

Background: Preterm delivery is one of the leading causes of neonatal mortality and morbidity. About 5 – 15% of pregnancies end up with preterm delivery. Early identification of pregnant women with a high risk for preterm delivery is one of the main goals of Obstetrics.

Setting: A Tertiary University Teaching Hospital in Lagos, Nigeria.

Design: A Retrospective Study.

Aim: To determine the rate of serum-d-dimer levels in predicting preterm labour in women admitted for threatening preterm labour.

Methods and Material: Pregnant women who were admitted to the Obstetrics & Gynecology ward of Lagos University Teaching Hospital for preterm labour were divided into two groups. In group I were n = 20 who delivered before 37 completed weeks and in group II were n = 33 who delivered after 37 completed weeks. Bishop's score, Cervical length measurement by abdominal ultrasound, Bilateral uterine artery Doppler and assay of serum d-dimer levels were carried out. After delivery, patients' characteristics were compared between the two groups. All that was analyzed statistically.

Results: Ultrasonographic cervical length of Bishop's scores and uterine artery R1 values were not significantly different. Maternal serum-d-dimer levels were 1460.2 ng/ml and 958.6 ng/ml in preterm and term delivery respectively. 3 (15%) patients in the preterm group versus 1 (3%) in the term delivery group had bilateral diastolic notches.

Conclusion: Serum d-Dimer concentration and uterine artery Doppler readings could be helpful in predicting preterm labour. More retrospective study is needed to rule the routine usage.

Keywords: Serum d-Dimer level, preterm labour, uterine artery Doppler.