Concentration of fibrin monomer in pregnancy and during the postpartum period. (November 2019)

• Record Type: Journal Article
• Authors: Kristoffersen, Ann Helen; Petersen, Per Hyltoft; Bjørge, Line; Røraas, Thomas; Sandberg, Sverre
• Is Part Of: Annals of clinical biochemistry. Volume 56:Number 6(2019:Nov.)
• Page Start: 692
• Page End: 700
• Publication Date: 2019-11
• Subjects: Coagulation testing -- pregnancy -- fibrin monomer -- D-dimer -- within-subject biological variation; Clinical chemistry -- Periodicals; Clinical biochemistry -- Periodicals; 616.075
• DOI: 10.1177/0004563219869732
• Languages: English
• ISSNs: 0004-5632

Abstract

Background: D-dimer increases during pregnancy and is problematic to use in the diagnosis of venous thromboembolism. Fibrin monomer represents an alternative biomarker for venous thromboembolism. However, to be useful in pregnancy, the fibrin monomer concentration should be stable throughout pregnancy and during postpartum. Methods: To describe the course of fibrin monomer concentration during pregnancy and the postpartum period in healthy pregnant women and to compare their within-subject biological variation (CVI ) with non-pregnant women. Blood samples were obtained every fourth week during pregnancy and three samples after delivery in 20 healthy women and every fourth week during a 40-week period in 19 healthy non-pregnant women. Fibrin monomer (STA Liatest FM, Stago) was analysed in duplicates for all samples. Concentrations of fibrin monomer in pregnant and non-pregnant women were compared and the CVI for fibrin monomer was calculated. Results: The median fibrin monomer concentration in pregnant women was 6.2 mg/L (2.5 and 97.5 percentiles 3.7–10.8 mg/L) and in non-pregnant women 4.8 mg/L (3.6–8.2) ( P < 0.01). The fibrin monomer concentration was relatively stable during pregnancy, although a few unexplained high fibrin monomer concentrations were found during pregnancy/postpartum. Fibrin monomer CVI in pregnancy and postpartum was 20.6% (95% CI 18.3, 23.5) and in non-pregnant 16.1% (13.7, 18.9). Conclusions: For clinical purposes, fibrin monomer concentration can be considered stable during pregnancy, although it is slightly higher than in non-pregnant women. Pregnant and non-pregnant women have the same CVI . The suitability of fibrin monomer in venous thromboembolism diagnosis in pregnant women should be validated in further studies.