D-Dimer in PE during pregnancy

Q: Negative D-Dimer rules out the pulmonary embolism (PE) in pregnancy?

A) True
B) False


Answer: B

D-dimer has a high false-negative rate in pregnancy. It also has a high false-positive rate in pregnancy. D-Dimer has no utility to rule out PE in pregnancy. D-Dimer is a physiologic response in pregnancy and rises during the course of a normal pregnancy. It declines slowly postpartum, and has no normal reference range!

#pulmonary
#OB-Gyn
#hematology


References:

1. Damodaram M, Kaladindi M, Luckit J, Yoong W. D-dimers as a screening test for venous thromboembolism in pregnancy: is it of any use? J Obstet Gynaecol 2009; 29:101. 

2.  To MS, Hunt BJ, Nelson-Piercy C. A negative D-dimer does not exclude venous thromboembolism (VTE) in pregnancy. J Obstet Gynaecol 2008; 28:222.