D-Dimer
- D-dimer assays have high negative predictive value in non-pregnant patients with suspected VTE and can be used to exclude the diagnosis. 3 Unfortunately, pregnancy causes d-dimer levels to increase even in uncomplicated cases, diminishing its usefulness.
- Recent attempts have been made to establish a normal range for d-dimer assays during pregnancy but have not been used in clinical practice. Studies show that d-dimer testing in the third trimester is almost certain to be of no clinical benefit as a d-dimer level above the reference range is probably universal. 4
- Despite this, it is intuitive that as in non-pregnant patients, a negative d-dimer in a patient at low risk of PE rules the diagnosis of PE out. 5
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