Research Article
Volume 10 Issue 9 - 2021
Evaluating the Value of Blood D-Dimers in Pregnant Women with Preeclampsia as a Predictor for Onset of HELLP Syndrome: Case Control Study
Oranye Benjamin Chukwuka*, Aimakhu Christopher and Oladapo Olayemi
Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Oyo State, Nigeria
*Corresponding Author: Oranye Benjamin Chukwuka, Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Oyo State, Nigeria.
Received: August 29, 2020; Published: August 16, 2021


Introduction: Preeclampsia is a common medical complication of pregnancy. It could be complicated by HELLP syndrome. HELLP syndrome is a multi-systemic disorder that complicates pregnancy with associated foeto-maternal morbidity and mortality. It could be a life-threatening obstetric complication. When diagnosed early and appropriate intervention instituted promptly, these complications can be picked early or even prevented.

Objective: This main aim of this study was to determine if the presence of blood D-dimers in women with preeclampsia is an early predictor of HELLP syndrome.

Methodology: This study was a prospective case-control study carried out at the Depart. of Obs. and Gyn., UCH and at AMTH, between November 2015 to April 2016. Ninety pregnant women with preeclampsia as cases and ninety with normal pregnancy as controls were recruited into the study before delivery and monitored till after delivery. Blood samples was collected for serum D-dimer assay. A structured proforma was utilised to extract socio-demographic, maternal obstetric history, and record results of tests. Data was collated and analysed using SPSS version 20. The level of significance was set at be P < 0.05.

Results: The mean age for cases was 31.4 years and controls was 31.3 years. The two groups were matched for GA. Caesarean section was the commoner route of delivery for preeclampsia patients. The mean d-dimer levels were elevated above the cut-off 0.5 mg/l in both groups. The pre-delivery was 3.37 mg/l and 1.47 mg/l and post-delivery was 3.22 mg/l and 3.14 mg/l for cases and controls respectively. This was statistically significant. (p-value < 0.001). Upon conclusion of the study, a higher proportion of the cases had elevated D-dimer levels (95.2%) compared to controls (89.5%). This was not statistically significant. (p-value 0.447). The prevalence of HELLP syndrome was 0.6% and only one patient with preeclampsia developed the syndrome while one patient without preeclampsia was diagnosed with the syndrome post-delivery. This was too low to perform a logistic regression and hence elevated D-dimer cannot be used to predict HELLP syndrome in the subjects from this study.

Conclusion: Elevated d-dimer levels were detected in patients with preeclampsia, but it was not predictive of HELLP syndrome due to low prevalence in our environment.

Keywords: Preeclampsia; HELLP Syndrome Prediction; D-Dimer; University College Hospital; Adeoyo Maternity Teaching Hospital; Feto-Maternal Complications


  1. Current Diagnosis and Treatment. Obstetrics and Gynecology. 10th McGraw-Hill, Medical Publishing Division. New York (2006).
  2. Weinstein L. "It has been a great ride: the history of HELLP syndrome". American Journal of Obstetrics and Gynecology 193 3-1(2005): 860-863.
  3. Mihu D., et al. “HELLP syndrome - a multisystemic disorder”. The Journal of Gastrointestinal and Liver Diseases 4 (2007): 419-424.
  4. Gleeson R., et al. “HELLP syndrome: a condition of varied presentation”. Irish Journal of Medical Science 165 (1996): 265-267.
  5. Osmanagaoglu MA., et al. “Comparison between HELLP syndrome, chronic hypertension, and superimposed preeclampsia on chronic hypertension without HELLP syndrome”. Journal of Perinatal Medicine 32 (2004): 481-485.
  6. Poldre PA. “Haptoglobin helps diagnose the HELLP syndrome”. American Journal of Obstetrics and Gynecology 157 (1987): 1267.
  7. Neiger R., et al. “D-dimer test for early detection of HELLP syndrome”. The Southern Medical Journal4 (1995): 416-419.
  8. Brenner B. “Haemostatic changes in pregnancy”. Thrombosis Research5-6 (2004): 409-414.
  9. Kline JA., et al. “D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed”. Clinical Chemistry5 (2005): 825-829.
  10. Heffner A and Kline J. “Role of the peripheral intravenous catheter in false-positive D-dimer testing”. Academic Emergency Medicine 8 (2001): 103-106.
  11. Linhares JJ., et al. “Factors associated with mode of delivery in women with pre-eclampsia”. Revista Brasileira de Ginecologia e Obstetrícia6 (2014): 259-263.
  12. Thomas L., et al. “LDH reference values”. The Journal of Laboratory Medicine5 (2005): 301-308.
  13. Proietti AB., et al. “Assessment of fibrinogen degradation products in preeclampsia using immunoblot, enzyme-linked immunosorbent assay, and latex-based agglutination”. Obstetrics and Gynecology5 (1991): 696-700.
  14. Rahman TM and Wendon J. “Severe hepatic dysfunction in pregnancy”. QJM: An International Journal of Medicine 95 (2002): 343-357.
  15. Sibai BM., et al. “Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia”. American Journal of Obstetrics and Gynecology 155 (1986): 501.
  16. Thefeld W., et al. “Referenzwerte fur die Bestimmungen der Transaminases GOT and GPT sowie der alakalischem phosphatase im serum mit optimierten Standard methoden”. Deutsche Medizinische Wochenschrift 93 (1974): 343-351.
  17. Neiger R., et al. “Plasma fibrin D-dimer in pregnancies complicated by partial placental abruption”. Tennessee Medical 10 (1997): 403-405.
Citation: Oranye Benjamin Chukwuka., et al. “Evaluating the Value of Blood D-Dimers in Pregnant Women with Preeclampsia as a Predictor for Onset of HELLP Syndrome: Case Control Study”. EC Gynaecology 10.9 (2021): 01-11.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

September Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the September issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 14, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.