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The normal values of laboratory tests change drastically during pregnancy, this article will serve as a guide for a correct interpretation and avoid unnecessary anxiety. Many changes can not be treated during pregnancy, especially those related to the elevation of blood lipids. So, if cholesterol and/or triglycerides rise abnormally during pregnancy, we will do nothing about it, at least nothing beyond limiting intake of sugars and fats in the diet a bit and increasing the level of exercise during the day. We will take care of this when the baby is 3 months old
The value of hemoglobin is very particular because it has a tendency to decrease considerably during pregnancy, in the first trimester there is talk of anemia with levels lower than 11 gr/dL and in trimesters 2-3 when it is less than 10.5 gr / dL. After childbirth there is talk of anemia when there are levels less than 10. The advantage of this physiological anemia is that by lowering blood viscosity the risk of thrombosis is also reduced.
TSH, the hormone that governs the thyroid, is the element that determines glandular function. In hypothyroid patients who use hormone (T4), the values should be kept at lower ranges than those used in non-pregnant women due to certain associations with loss of pregnancy and other fetal complications (NEJM Negro et al., 95 (9) 2010). If the value of TSH is greater than or equal to 2.50 IU/L, the patient will receive treatment with thyroid hormone (T4) throughout pregnancy to prevent fetal neurological development disorders. The normal value for the rest of the pregnancy is less than 3.0 IU / L (this point was updated with new values, 2016. Check my article on hypothyroidism )
The elevation of white blood cells is normal in pregnancy and can generate doubts of infection from other specialties. You have to be very careful with the interpretation of this data to avoid inappropriate treatments.
Insulin, we do not measure insulin since its values are altered in pregnancy; In addition, normal pregnancy is a natural state of insulin resistance.
Normal values in the laboratory of the pregnant woman
|
not
pregnant
|
pregnant
|
|
|---|---|---|
| hemoglobin (mg / dL) |
12-16
|
11-14
|
| hematocrit (%) |
37-47
|
33-44
|
| white blood cells |
4,500-11,000
|
6,000-16,000
|
| platelets (x1000) |
130-400
|
>100
|
| fibrinogen (mg / dL) |
200-450
|
400-650
|
| urea (BUN) |
10-20
|
5-12
|
| creatinine (mg / dL) |
<1.5
|
<0.8
|
| uric acid (mg / dL) |
1.5-6.0
|
1.2-4.5
|
| glycemia (mg / dL) |
75-100
|
60-105
|
| glucose overload 50, one hour (mg / dL) |
NA
|
<140
|
| glucose overload 75, two hours: fast (mg / dL) |
60-100
|
<95
|
|
1 hour
|
<200
|
<180
|
|
2 hours
|
<140
|
<155
|
| calcium (mg / dL) |
9.0-10.5
|
8.1-9.5
|
| cholesterol (mg / dL) |
<200
|
<280
|
| triglycerides (mg / dL) |
<160
|
<260
|
| TSH (thyroid), first trimester (UI) |
0.5-5.0
|
<2.5
|
| TSH (thyroid), 2 and 3 trimesters (UI) |
0.5-5.0
|
<3.0
|
| Vitamin D (ng / mL), 25OH Vitamin D |
> 32
|
> 32 (40-60?)
|
| albumin (g / dL) |
3.5-5.5
|
2.5-4.5
|
| prolactin (ng / mL) |
2-15
|
50-400
|
| proteinuria 24 hs (mg) |
<150
|
<300
|
| Uroculture (UFC) |
negative
|
negative
|
| Rubella, Toxoplasmosis, Cytomegalovirus (CMV):
IgG + |
*
infection,
past
*
|
past infection,
isn’t a problem
|
| Rubella, Toxoplasmosis, Cytomegalovirus (CMV):
IgM + |
infection,
recent
|
recent infection,
may be a problem
|
BhCG
|
Weeks of pregnancy
|
Levels of Beta- hCG mUI
|
|
3-4
|
9 -130
|
|
4-5
|
75 – 2600
|
|
5-6
|
850 – 20800
|
|
6-7
|
4000 – 100200
|
|
7-12
|
11500 – 289000
|
|
12-16
|
18300 – 137000
|
|
16-19
|
1400 – 53000
|
|
19-41
|
940 – 60000
|
The pregnancy hormone ranges (B hCG ) are very broad and do not really help much to determine the gestational age of pregnancy.
The quantitative value is useful in the diagnosis of Ectopic Pregnancy or to determine the point from which an intrauterine pregnancy should be diagnosed by high resolution transvaginal ultrasound.
Cholesterol
Many patients become frightened because of the considerable increase in cholesterol levels during their pregnancy.
Cholesterol: the basis of all the steroid hormones, the ring ciclopentanoperhydrofenantrene
Progesterone, the hormone that allows pregnancy with levels 4-8 times higher:
Estriol, estrogen, its levels are 1000 times higher during pregnancy:
They all look alike because they are modifications of cholesterol.
Cholesterol is the basis of progesterone and other hormones needed during pregnancy therefore high levels are needed to provide the substrate for its synthesis. Its normal plasma value in pregnancy increases up to 280 mg/dL. When these limits are exceeded we do not indicate any treatment since the medications used to lower their levels are contraindicated during pregnancy.
All values of Laboratory in Pregnancy