Comparative Study of D-Dimer Changes in Women with Gestational Diabetes and Healthy Women after Elective Cesarean Section
Abstract
Background: D-dimer levels in the blood are analyzed to diagnose conditions such as deep vein thrombosis, aortic rupture, certain types of acute headaches resulting from vascular disorders, and pulmonary embolism. D-dimer levels can also be a determining factor in the prognosis of various cancers. This study aimed to compare D-dimer changes in women with gestational diabetes mellitus (GDM) to those in healthy women following elective cesarean section.
Methods: This study, based on the Iran ICU Registry (IICUR), collected data on women hospitalized in the women’s ICU. Data were extracted from the registry using a standardized checklist. The study method involved extracting information on women with GDM and healthy women from the registry checklist and patient clinical records, including laboratory results. All D-dimer measurements were performed using a standardized laboratory kit within the hospital and were documented in the patients’ clinical records.
Results: The findings showed no significant difference in D-dimer levels on the first day after the CS. Additionally, there was a positive correlation between D-dimer levels and both advanced maternal age and higher BMI, with D-dimer levels rising as age and BMI increased among the study participants.
Conclusion: Higher levels of D-dimer were detected in patients with gestational diabetes mellitus (GDM) compared to healthy women after cesarean delivery. These results indicate a potentially elevated risk of deep vein thrombosis (DVT) in women with GDM undergoing elective CS, underscoring the importance of targeted preventive and therapeutic measures.
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[7] Honari, S., Asoudeh, M., Tara, F., Najaf Najafi, M., Khadem-Rezaiyan, M. Epidemiological Characteristics, Economic Burden and Trend of Changes in Cesarean Sections Performed in Medical University Educational Centers in Mashhad City: A 12-Year Study. Iran J Obstet Gynecol Infertil. 2023; 26(7): 12-24.
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[9] Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. The effects of abdominal binder on wound healing and consumed pain medications after cesarean section: A randomized control trial. Iran Red Crescent Med J. 2017; 19(4):e44119.
[10] Vahedparast H, Akaberian S, Hajinejad F, Tavallali F, Bagherzadeh R. Two methods of foot reflexology and Benson relaxation on pain and analgesics received by women undergoing caesarean section: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2023; 26(8): 19-32.
[11] Mascarello KC, Horta BL, Silveira MF. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Rev Saude Publica. 2017;51:105.
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[13] Easter SR, Rouse CE, Duarte V, Hynes JS, Singh MN, Landzberg MJ, et al. Planned vaginal delivery and cardiovascular morbidity in pregnant women with heart disease. Am J Obstet Gynecol. 2020;222(1):77. e1-.e11.
[14] Stone S, Nelson-Piercy C. Respiratory disease in pregnancy. Obstet Gynaecol Reprod Med. 2007;17(5):140-6.
[15] Andualem Z, Azene ZN, Azanaw J, Taddese AA, Dagne H. Acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in northwest, Ethiopia. Environ Health Prev Med. 2020;25(1):20.
[16] Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am. 2007; 34(2):173-99.
[17] Salajegheh Tezerji F, Salari R, Mazloum SR, Akhlaghi F, Babazadeh R. The efficacy of the oral capsule of aqueous alcoholic extract of red onion on blood sugar of women with gestational diabetes treated with diet. Iran J Obstet Gynecol Infertil. 2023;26(6):72-82.
[18] Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil. 2013;15(40):16-23.
[19] Eghdam-Zamiri R, Khanbabayi Gol M. Effects of ginger capsule on treatment of nausea and vomiting in patients receiving cisplatin undergoing mastectomy: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2020;22(11):15-21.
[20] Alvandfar D, Alizadeh M, Khanbabayi Gol M. Prevalence of pregnancy varicose and its effective factors in women referred to gynecology hospitals in Tabriz. Iran J Obstet Gynecol Infertil. 2019;22(9):1-7.
[21] Mallah F, Zeinalzadeh M, Alvandfar D. Changes of D dimer in women with gestational diabetes and healthy women after elective cesarean section. Iran J Obstet Gynecol Infertil. 2021;24(10):1-7.
[22] Pournajafian A, Rokhtabnak F, Ghodrati M, Kholdebarin A, Hassani A, Dayani A. Comparison of the effect of phenylephrine and ephedrine on the neonate in treatment of hypotension due to spinal anesthesia in pregnant women candidate for cesarean section. Iran J Obstet Gynecol Infertil. 2020;23(1):7-18.
[23] Sachdeva A, Dalton M, Amaragiri SV, Lees T. Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev. 2010(7).
[24] Goldhaber SZ, Fanikos J. Prevention of deep vein thrombosis and pulmonary embolism. Circulation. 2004;110(16):e445-e7.
[25] Miyamoto K, Komatsu H, Nagaya Y, Tsukihara S, Sarugami M, Osaku D, et al. Changes in serum D-dimer level and effect of enoxaparin sodium after a cesarean section: a retrospective study. J Matern Fetal Neonatal Med. 2022;35(3):509-14.
[26] Zhang L, Chen Y, Liu W, Wang X, Zhang S, Zhang W, et al. Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section. BMC Pulmonary Medicine. 2021;21(1):391.
[27] Matsumura Y, Yamamoto Y, Kikuchi I, Takahashi N, Matsuda Y, Saito T, et al. Early detection of thrombosis after cesarean section using changes in D-dimer levels. Hypertension Research in Pregnancy. 2014;2(1):26-9.
[28] Hedengran KK, Andersen MR, Stender S, Szecsi PB. Large D‐dimer fluctuation in normal pregnancy: A longitudinal cohort study of 4,117 samples from 714 Healthy Danish Women. Obstet Gynecol Int. 2016;2016(1):3561675.
[2] Ali-Akbari Sichani B, Darooneh T, Rashidi Fakari F, Moattar F, Nasiri M, Delpak-Yeganeh S, et al. Effect of crocus sativus (saffron) on cervical ripening and progress of labor in primiparous term women: A randomized double-blind placebo-controlled trial. Int J Pediatr. 2020;8(9):12105-15.
[3] Ghorashi Z, Sayadi AR, Allahbakhshinasab P. The Effect of flaxseed on cervical ripening and delivery outcome in primiparous women: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2024;27(3):1-9.
[4] Aneja S. Integrated management of newborn and childhood illness (IMNCI) strategy and its implementation in real life situation. The Indian Journal of Pediatrics. 2019;86(7):622-7.
[5] Janbabaee G, Moosazadeh M, Agah R, Khani S, Nezammahalleh A, Fallah M. Trend of cesarean section and natural childbirth in governmental and private hospitals during 2007-2014 and its 2021 forecast in Mazandaran province. Iran. J Mazandaran Univ Med Sci. 2016;25(134):1-11.
[6] Amiri M, Raei M, Chaman R, Rezaee N. Investigating some of the factors influencing choice of delivery type in women working in Shahroud University of Medical Sciences. Qom University of Medical Sciences. 2013; 20(1066):1-9.
[7] Honari, S., Asoudeh, M., Tara, F., Najaf Najafi, M., Khadem-Rezaiyan, M. Epidemiological Characteristics, Economic Burden and Trend of Changes in Cesarean Sections Performed in Medical University Educational Centers in Mashhad City: A 12-Year Study. Iran J Obstet Gynecol Infertil. 2023; 26(7): 12-24.
[8] Dorosti A, Mallah F, Ghavami Z. Effects of Foot Reflexology on Post-Cesarean Pain: A Randomized Clinical Trial. J Biochem Technol. 2019;10(2-2019):170-4.
[9] Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. The effects of abdominal binder on wound healing and consumed pain medications after cesarean section: A randomized control trial. Iran Red Crescent Med J. 2017; 19(4):e44119.
[10] Vahedparast H, Akaberian S, Hajinejad F, Tavallali F, Bagherzadeh R. Two methods of foot reflexology and Benson relaxation on pain and analgesics received by women undergoing caesarean section: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2023; 26(8): 19-32.
[11] Mascarello KC, Horta BL, Silveira MF. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Rev Saude Publica. 2017;51:105.
[12] Bergholt T, Stenderup JK, Vedsted-Jakobsen A, Helm P, Lenstrup C. Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors. Acta Obstet Gynecol Scand. 2003; 82(3):251-6.
[13] Easter SR, Rouse CE, Duarte V, Hynes JS, Singh MN, Landzberg MJ, et al. Planned vaginal delivery and cardiovascular morbidity in pregnant women with heart disease. Am J Obstet Gynecol. 2020;222(1):77. e1-.e11.
[14] Stone S, Nelson-Piercy C. Respiratory disease in pregnancy. Obstet Gynaecol Reprod Med. 2007;17(5):140-6.
[15] Andualem Z, Azene ZN, Azanaw J, Taddese AA, Dagne H. Acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in northwest, Ethiopia. Environ Health Prev Med. 2020;25(1):20.
[16] Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am. 2007; 34(2):173-99.
[17] Salajegheh Tezerji F, Salari R, Mazloum SR, Akhlaghi F, Babazadeh R. The efficacy of the oral capsule of aqueous alcoholic extract of red onion on blood sugar of women with gestational diabetes treated with diet. Iran J Obstet Gynecol Infertil. 2023;26(6):72-82.
[18] Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil. 2013;15(40):16-23.
[19] Eghdam-Zamiri R, Khanbabayi Gol M. Effects of ginger capsule on treatment of nausea and vomiting in patients receiving cisplatin undergoing mastectomy: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2020;22(11):15-21.
[20] Alvandfar D, Alizadeh M, Khanbabayi Gol M. Prevalence of pregnancy varicose and its effective factors in women referred to gynecology hospitals in Tabriz. Iran J Obstet Gynecol Infertil. 2019;22(9):1-7.
[21] Mallah F, Zeinalzadeh M, Alvandfar D. Changes of D dimer in women with gestational diabetes and healthy women after elective cesarean section. Iran J Obstet Gynecol Infertil. 2021;24(10):1-7.
[22] Pournajafian A, Rokhtabnak F, Ghodrati M, Kholdebarin A, Hassani A, Dayani A. Comparison of the effect of phenylephrine and ephedrine on the neonate in treatment of hypotension due to spinal anesthesia in pregnant women candidate for cesarean section. Iran J Obstet Gynecol Infertil. 2020;23(1):7-18.
[23] Sachdeva A, Dalton M, Amaragiri SV, Lees T. Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev. 2010(7).
[24] Goldhaber SZ, Fanikos J. Prevention of deep vein thrombosis and pulmonary embolism. Circulation. 2004;110(16):e445-e7.
[25] Miyamoto K, Komatsu H, Nagaya Y, Tsukihara S, Sarugami M, Osaku D, et al. Changes in serum D-dimer level and effect of enoxaparin sodium after a cesarean section: a retrospective study. J Matern Fetal Neonatal Med. 2022;35(3):509-14.
[26] Zhang L, Chen Y, Liu W, Wang X, Zhang S, Zhang W, et al. Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section. BMC Pulmonary Medicine. 2021;21(1):391.
[27] Matsumura Y, Yamamoto Y, Kikuchi I, Takahashi N, Matsuda Y, Saito T, et al. Early detection of thrombosis after cesarean section using changes in D-dimer levels. Hypertension Research in Pregnancy. 2014;2(1):26-9.
[28] Hedengran KK, Andersen MR, Stender S, Szecsi PB. Large D‐dimer fluctuation in normal pregnancy: A longitudinal cohort study of 4,117 samples from 714 Healthy Danish Women. Obstet Gynecol Int. 2016;2016(1):3561675.
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How to Cite
1.
Araiana S, Adhami Moghadam P, Azimi B. Comparative Study of D-Dimer Changes in Women with Gestational Diabetes and Healthy Women after Elective Cesarean Section. Arch Anesth & Crit Care. 2025;.
