Pregnancy
Maternal physiology
Maternal physiology changes so dramatically during pregnancy that reference intervals for biochemical tests in non-pregnant women are often not applicable. The main differences in commonly requested tests are shown in Table 76.1. These differences should not be misinterpreted as indicating that some pathology is present.
Table 76.1
Reference intervals in the third trimester of pregnancy, and how they compare with non-pregnant controls
Serum/blood measurement | Pregnant | Non-pregnant |
Potassium (mmol/L) | 3.2–4.6 | 3.5–5.3 |
Chloride (mmol/L) | 97–107 | 95–108 |
Bicarbonate (mmol/L) | 18–28 | 22–29 |
Urea (mmol/L) | 1.0–3.8 | 2.5–7.8 |
Glucose (fasting) (mmol/L) | 3.0–5.0 | 4.0–5.5 |
Adjusted Calcium (mmol/L) | 2.2–2.8 | 2.2–2.6 |
Magnesium (mmol/L) | 0.6–0.8 | 0.7–1.0 |
Albumin (g/L) | 32–42 | 35–50 |
Bilirubin (µmol/L) | <15 | <21 |
Alanine aminotransferase (U/L) | 3–28 | 3–55 |
Aspartate aminotransferase (U/L) | 3–31 | 12–48 |
Alkaline phosphatase (U/L) | 174–400 | 30–130 |
Blood H+ (nmol/L) | 34–50 | 35–45 |
Blood PCO2 (kPa) | 3.0–5.0 | 4.4–5.6 |
Weight gain
The products of conception. These include the fetus, placenta and amniotic fluid.
Maternal fat stores. These may account for up to 25% of the weight increase.
Maternal water retention. Total body water increases by about 5 L, mostly in ECF. The volume of the intravascular compartment increases by more than 1 L.