Professional Documents
Culture Documents
Labs-Para-Embarazo 78 0
Labs-Para-Embarazo 78 0
VOL. 114, NO. 6, DECEMBER 2009 Abbassi-Ghanavati et al Laboratory Values in Pregnancy 1327
Table 1. Normal Reference Ranges in Pregnant Women
Nonpregnant First Second Third
AdultA Trimester Trimester Trimester ReferencesB
HEMATOLOGY
ErythropoietinC (U/L) 4–27 12–25 8–67 14–222 7, 10, 47
FerritinC (ng/mL) 10–150D 6–130 2–230 0–116 7, 10, 39, 42, 45, 47, 62, 70
Folate, red blood cell (ng/mL) 150–450 137–589 94–828 109–663 45, 46, 72
Folate, serum (ng/mL) 5.4–18.0 2.6–15.0 0.8–24.0 1.4–20.7 7, 43, 45, 46, 53, 58, 72
HemoglobinC (g/dL) 12–15.8D 11.6–13.9 9.7–14.8 9.5–15.0 10, 45, 47, 58, 62
HematocritC (%) 35.4–44.4 31.0–41.0 30.0–39.0 28.0–40.0 6, 7, 10, 42, 45, 58, 66
Iron, total binding capacityC (g/dL) 251–406 278–403 Not reported 359–609 62
Iron, serumC (g/dL) 41–141 72–143 44–178 30–193 10, 62
Mean corpuscular hemoglobin (pg/cell) 27–32 30–32 30–33 29–32 42
Mean corpuscular volume (m3) 79–93 81–96 82–97 81–99 6, 42, 45, 58
Platelet (⫻109/L) 165–415 174–391 155–409 146–429 4, 6, 16, 42, 45
Mean platelet volume (m3) 6.4–11.0 7.7–10.3 7.8–10.2 8.2–10.4 42
Red blood cell count (⫻106/mm3) 4.00–5.20D 3.42–4.55 2.81–4.49 2.71–4.43 6, 42, 45, 58
Red cell distribution width (%) ⬍14.5 12.5–14.1 13.4–13.6 12.7–15.3 42
White blood cell count (⫻103/mm3) 3.5–9.1 5.7–13.6 5.6–14.8 5.9–16.9 6, 9, 42, 45, 58
Neutrophils (⫻103/mm3) 1.4–4.6 3.6–10.1 3.8–12.3 3.9–13.1 4, 6, 9, 42
Lymphocytes (⫻103/mm3) 0.7–4.6 1.1–3.6 0.9–3.9 1.0–3.6 4, 6, 9, 42
Monocytes (⫻103/mm3) 0.1–0.7 0.1–1.1 0.1–1.1 0.1–1.4 6, 9, 42
Eosinophils (⫻103/mm3) 0–0.6 0–0.6 0–0.6 0–0.6 6, 9
Basophils (⫻103/mm3) 0–0.2 0–0.1 0–0.1 0–0.1 6, 9
Transferrin (mg/dL) 200–400 254–344 220–441 288–530 39, 42
Transferrin, saturation without iron (%) 22–46C Not reported 10–44 5–37 47
Transferrin, saturation with iron (%) 22–46C Not reported 18–92 9–98 47
COAGULATION
Antithrombin III, functional (%) 70–130 89–114 88–112 82–116 15, 16
D–dimer (g/mL) 0.22–0.74 0.05–0.95 0.32–1.29 0.13–1.7 16, 25, 35, 51
Factor V (%) 50–150 75–95 72–96 60–88 40
Factor VII (%) 50–150 100–146 95–153 149–211 16
Factor VIII (%) 50–150 90–210 97–312 143–353 16, 40
Factor IX (%) 50–150 103–172 154–217 164–235 16
Factor XI (%) 50–150 80–127 82–144 65–123 16
Factor XII (%) 50–150 78–124 90–151 129–194 16
Fibrinogen (mg/dL) 233–496 244–510 291–538 373–619 16, 25, 42, 51
Homocysteine (mol/L) 4.4–10.8 3.34–11 2.0–26.9 3.2–21.4 43, 45, 46, 53, 72
International Normalized Ratio 0.9–1.04G 0.89–1.05 0.85–0.97 0.80–0.94 15
Partial thromboplastin time, activated 26.3–39.4 24.3–38.9 24.2–38.1 24.7–35.0 15, 16, 42
(sec)
Prothrombin time (sec) 12.7–15.4 9.7–13.5 9.5–13.4 9.6–12.9 16, 42
Protein C, functional (%) 70–130 78–121 83–133 67–135 15, 24, 40
Protein S, total (%) 70–140 39–105 27–101 33–101 16, 24, 40
Protein S, free (%) 70–140 34–133 19–113 20–65 24, 40
Protein S, functional activity (%) 65–140 57–95 42–68 16–42 40
Tissue plasminogen activator (ng/mL) 1.6–13I 1.8–6.0 2.4–6.6 3.3–9.2 15, 16
Tissue plasminogen activator 4–43 16–33 36–55 67–92 16
inhibitor-1 (ng/mL)
von Willebrand factor (%) 75–125 Not reported Not reported 121–260 73
BLOOD CHEMICAL
CONSTITUENTS
Alanine transaminase (U/L) 7–41 3–30 2–33 2–25 5, 39, 42, 70
Albumin (g/dL) 4.1–5.3D 3.1–5.1 2.6–4.5 2.3–4.2 3, 5, 26, 29, 39, 42, 72
Alkaline phosphatase (U/L) 33–96 17–88 25–126 38–229 3, 5, 39, 42, 70
Alpha-1 antitrypsin (mg/dL) 100–200 225–323 273–391 327–487 42
Amylase (U/L) 20–96 24–83 16–73 15–81 32, 39, 42, 68
Anion gap (mmol/L) 7–16 13–17 12–16 12–16 42
Aspartate transaminase (U/L) 12–38 3–23 3–33 4–32 5, 39, 42, 70
(continued)
VOL. 114, NO. 6, DECEMBER 2009 Abbassi-Ghanavati et al Laboratory Values in Pregnancy 1329
Table 1. Normal Reference Ranges in Pregnant Women (continued)
Nonpregnant First Second Third
AdultA Trimester Trimester Trimester ReferencesB
the possibility that there may be variations between sequelae of hypertension, diabetes, and lipid derange-
racial groups, regions of the world, and timing of ment, pregnant women with significant cardiac dis-
sample collection that cannot be fully examined. ease are becoming more common. Accordingly, ad-
Practitioners using this table should be cognizant of ditional research of normal values of these increasingly
any underlying medical conditions or racial predispo- used laboratory studies is needed. Despite these lim-
sitions that would modify laboratory results in the itations, the table as published should provide a quick
nonpregnant woman because the values generally reference for most values needed to provide care for
found during pregnancy may not be representative of the pregnant woman.
an individual patient’s values.
Finally, there remains a list of laboratory analytes REFERENCES
1. Hytten FE, Lind T. Diagnostic indices in pregnancy. Summit
that have not been evaluated for pregnancy-induced (NJ): CIBA-GEIGY Corporation; 1975.
deviations from normal values. Most notable are the 2. Larsson A, Palm M, Hansson LO, Axelsson O. Reference
values for tests used in cardiac evaluation such as values for clinical chemistry tests during normal pregnancy.
atrial natriuretic peptide, B-type natriuretic peptide, BJOG 2008;115:874 – 81.
troponin, creatine kinase, and creatine kinase-MB. At 3. Lockitch G. Handbook of diagnostic biochemistry and hematol-
ogy in normal pregnancy. Boca Raton (FL): CRC Press; 1993.
a time where increasing numbers of women are
4. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL,
delaying pregnancy until middle-age in a population Jameson JL, et al, editors. Harrison’s principles of internal
with epidemic rates of obesity and its metabolic medicine. 17th ed. New York (NY): McGraw-Hill; 2008.
VOL. 114, NO. 6, DECEMBER 2009 Abbassi-Ghanavati et al Laboratory Values in Pregnancy 1331