d-Dimer levels during pregnancy and postpartum: non-applicability of regularly used cut-offs for diagnosis of suspected pulmonary embolism

Nearly all pregnant and postpartum women exceed conventional D-dimer thresholds also in the absence of thromboembolism. Standard cut-offs of 0.5 and 1.0 mg/L are therefore unsuitable in obstetric practice, limiting the applicability of general diagnostic algorithms, such as YEARS and Geneva, unless specifically adapted. Trimester- and postpartum-adjusted thresholds or alternative biomarkers are needed to reduce unnecessary imaging and improve clinical management.