Changes in D-dimer levels after cesarean section in women with singleton and twin pregnancies

Abstract Objective To determine how the D-dimer level changes after cesarean section, a topic that has not been studied extensively. Methods The D-dimer level (μg/mL) was measured in 792 and 119 women with singleton and twin pregnancies, respectively, on the day or one day before cesarean section and on postpartum days 1, 3, and 7. None of the women developed venous thromboembolism with clinical symptoms. The data for other two women who underwent a cesarean section and developed pulmonary thromboembolism on postpartum days 0 to 1 were also presented. Results The preoperative D-dimer level (median, μg/mL) of 2.4 increased on postpartum day 1 to 6.0, then decreased to 2.8 on postpartum day 3, and again increased to 4.5 on postpartum day 7 in the singleton pregnancies. A similar pattern, but with slightly higher values, was seen in the twin pregnancies. The 95 percentile value of D-dimer for singleton and twin pregnancies was 6.9 and 10.5 on days – 1/0, 19.7 and 25.7 on day 1, 9.7 and 13.5 on day 3, and 15.7 and 17.7 on day 7, respectively. The D-dimer level after pulmonary thromboembolism was greater than the 99 percentile value and the 98 percentile value in the two women, respectively. Conclusion Our data regarding the D-dimer level may be helpful when considering the normal range of D-dimer for postpartum women with cesarean delivery.