Umbilical venous D-dimer concentrations with and without labor.
OBJECTIVE
To determine if labor activates the fetal fibrinolytic system.


METHODS
A total of 59 umbilical venous blood samples were collecting following vaginal delivery at term (n = 20), cesarean delivery following labor at term (n = 12), vaginal delivery before term (n = 18), and cesarean delivery without labor (n = 9). D-dimer concentrations, a sensitive marker of fibrinolysis, were measured by enzyme-linked immunosorbent assay, and compared between groups by Kruskel-Wallis and Mann Whitney U tests, with significance defined as P < .05.


RESULTS
There were no significant differences in median D-dimer concentrations between newborns delivered vaginally or by cesarean after term labor or preterm labor. There were significant differences in median umbilical venous D-dimer concentrations in subjects delivered vaginally or by cesarean after term or preterm labor compared with term subjects without labor delivered by cesarean (427, 773, and 326 versus 87 ng/mL, P = .01).


CONCLUSIONS
Elevation of umbilical plasma D-dimer concentrations in laboring patients suggests activation of fetal fibrinolysis before delivery.
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA. murth002@mc.duke.edu
A P
AP
Murtha
K A
KA
Boggess
C E
CE
Jimmerson
P C
PC
Greig
W N
WN
Herbert
D000328:Adult; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy
D005338:Fibrin Fibrinogen Degradation Products