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IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Archives of Gynecology and Obstetrics Pub Date : 2025-01-28 DOI:10.1007/s00404-025-07940-9

Gizem Aktemur, Betül Tokgöz Çakır, Gülşan Karabay, Can Ozan Ulusoy, Zeynep Seyhanlı, Serap Topkara Sucu, Nazan Vanlı Tonyalı, Can Tekin İskender

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引用次数: 0

摘要

导言：妊娠会诱发高凝状态，其特点是凝血因子增加、抗凝剂减少，同时纤维蛋白溶解持续进行，D-二聚体（DD）水平升高。由于这些变化，妊娠期的 DD 参考值往往超过非妊娠期的临界值。DD 水平升高在妊娠晚期很常见，可能与妊娠糖尿病、高血压和早产等并发症有关，尤其是在胎膜早破（PPROM）的情况下。本研究调查了 DD 水平、从诊断为胎膜早破到分娩的持续时间与新生儿预后之间的关系：这项回顾性研究于 2022 年 10 月至 2023 年 5 月在土耳其安卡拉 Etlik 市医院围产医学科进行。研究共纳入了 80 名妊娠 24 至 36 周的早产儿。每隔一天对患者进行一次常规血液检查和凝血参数（包括 DD）监测，为期两周。根据患者是否在确诊 PPROM 后 7 天内分娩，将其分为两个亚组。统计分析包括 Mann-Whitney U 检验、Student's t 检验、Chi-square 检验、Friedman 检验、Durbin-Conover 检验、广义估计方程（GEE）和 ROC 分析：入院时的胎龄在早产儿娩出后 7 天以后的患者中明显较低。超声测量结果显示，早产组的胎儿参数较大，存在明显差异。第三次随访时较高的DD水平与较短的分娩时间相关（p = 0.021）。纵向分析表明，随着时间的推移，特别是临近分娩时，DD 水平会出现明显波动。GEE分析表明，DD水平与分娩时间之间存在很强的反比关系（p = 0.004），ROC分析（AUROC = 0.811）也证实了这一点：结论：DD水平升高与PPROM诊断到分娩的时间缩短有关，表明其在预测分娩开始方面具有潜在的实用性。监测 DD 水平有助于临床决策，包括新生儿护理计划和干预时机的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The role of D-dimer changes in predicting delivery time in preterm premature rupture of membranes: a retrospective analysis.

Introduction: Pregnancy induces a hypercoagulable state, characterized by increased coagulation factors and decreased anticoagulants, alongside ongoing fibrinolysis marked by elevated D-dimer (DD) levels. Reference values for DD in pregnancy often exceed the non-pregnant cutoff due to these changes. Elevated DD levels are common in late pregnancy and may correlate with complications such as gestational diabetes, hypertension, and preterm delivery, particularly in cases of preterm premature rupture of membranes (PPROM). This study investigates the association between DD levels, the duration from PPROM diagnosis to delivery, and neonatal outcomes.

Methods: This retrospective study was conducted at the Department of Perinatology, Etlik City Hospital, Ankara, Turkey, from October 2022 to May 2023. Eighty patients with PPROM between 24 and 36 weeks of gestation were included. Routine blood tests and coagulation parameters, including DD, were monitored every other day for 2 weeks. Patients were classified into two subgroups based on whether labor occurred within 7 days of PPROM diagnosis. Statistical analyses included the Mann-Whitney U test, Student's t test, Chi-square test, Friedman test, Durbin-Conover test, generalized estimating equations (GEE), and ROC analysis.

Results: Gestational age at admission was significantly lower in patients who delivered later than 7 days post-PPROM. Significant differences were observed in ultrasonographic measurements, with larger fetal parameters in the early delivery group. Higher DD levels at the third follow-up correlated with shorter durations to delivery (p = 0.021). Longitudinal analysis showed significant fluctuations in DD levels over time, particularly near delivery. The GEE analysis demonstrated a strong inverse relationship between DD levels and time to delivery (p = 0.004), supported by ROC analysis (AUROC = 0.811).

Conclusions: Elevated DD levels are associated with shorter durations from PPROM diagnosis to delivery, indicating their potential utility in predicting labor onset. Monitoring DD levels may help in clinical decision-making for managing PPROM, including planning neonatal care and timing of interventions.

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来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.