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Forum Name: Clots & Anticoagulants

Question: high d-dimer postpartum


 rene - Sun Dec 02, 2007 1:32 pm

I am 36 and had a baby two months ago. i was feeling really sick and short of breath 4 days postpartum and had a d-dimer done- at that time it was 3500 with a reference range of 0-500. the also did a lung ct that came back negative for PE.

i began having chest pain a few days ago and went the ER last night. all heart tests came back fine but my d-dimer was still elevated at 1.5 with reference range being 0-0.5. they did not do another lung ct becuase i would not be able to breast feed. i was wondering what else that elevated number could mean and could it have anything to do with my menstrual cycle? is it good that it has come down in 8 weeks or should it be all the way down by now??

please help i am really nervous about it
 Dr. Chan Lowe - Fri Jan 04, 2008 10:51 pm

User avatar Hi Rene,

D-dimers are a factor that becomes elevated when blood clots split up some. An elevation in the level would be indicative of some clotting in the bloodstream somewhere. This test is often used to help detect a pulmonary embolism since, in cases where there is shortness of breath and other symptoms of a PE, an elevated D-dimer is expected to be coming from a clot in the lung blood vessels.

However, the d-dimer test is not specific for clots in the lungs. If there was clotting somewhere else it would also cause an elevation in the test. With a negative CT scan the probability of there being a PE goes down significantly. Very small clots in the small blood vessels may be missed but these are less likely to be clinically significant.

Following pregnancy, there is likely to be clotting in the uterus (normal to help prevent bleeding following delivery of the placenta). This would also make the d-dimer go up. I am not familiar with the exact amount of elevation that would be expected in this case, though.

I suspect that since your levels are coming down it is likely related to your pregnancy and is less likely to be significant. I would recommend you follow up with your doctor to be sure.

Best wishes.

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