Read Oxford Handbook of Midwifery Online
Authors: Janet Medforth,Sue Battersby,Maggie Evans,Beverley Marsh,Angela Walker
428
CHAPTER 19
Emergencies
Table 19.4
Blood chemistry valves in pregnancy: detecting deviations from normal
Test Non-pregnant | Pregnancy | PIH/PET | DIC Notes | Causes of abnormal result |
Biochemistry | ||||
Sodium (mmol/L | 132–144 | – | – Fall to lower end of non- | Low sodium in |
pregnant range. Body | hyperemesis | |||
sodium increases in | ||||
pregnancy but levels | ||||
unchanged due to water | ||||
retention | ||||
Potassium (mmol/L | 3.6–5.1 | May (i) | – Raised levels represent | PIH, HELLP, primary renal |
deterioration of renal | disease. | |||
function | ||||
Urea (mmol/L | 2.3–4.3 | (i) | – Normally d due to | PIH, HELLP, primary renal |
increased renal blood flow. | disease | |||
Raised levels represent | ||||
deterioration of renal | ||||
function | ||||
Creatinine (μmol/L | 50–73 | (i) | – | |
Chloride (mmol/L | 95–107 | – | – | |
Uric acid (mmol/L | 0.15–0.35 | (i) | – Raised levels represent | PIH, HELLP, primary renal |
deterioration of renal | disease. | |||
function |
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BLOOD TESTS RESULTS DURING PREGNANCY
Test | Non-pregnant | Pregnancy | PIH/PET | DIC | Notes | Causes of abnormal result |
Liver function tests | ||||||
Total protein (g/L | 78 (60–80) | 70 | (d) to (d d) | – | Normally just below non- | PIH, HELLP |
pregnant reference range. | ||||||
Increased loss of protein | ||||||
and decreased production | ||||||
due to liver dysfunction in | ||||||
PIH/HELLP | ||||||
Albumin (g/L | 45 (36–47) | 33 | (d) to (d d) | – | ||
ALT (U/L | 10–40 | 10–40 | May (i) | – | Raised levels indicate | PIH, HELLP, primary liver |
hepatic cellular damage. | disease | |||||
Levels slightly i post | ||||||
partum | ||||||
AST (U/L | 10–35 | 10–35 | May (i) | – | ||
G-glutamyl transpeptidase (U/L | 7–50 | 7–50 | – | – | No significant change | Alcohol abuse. enzyme- inducing drugs such as |
barbiturates and warfarin |