Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++Table Graphic Jump LocationView Table||Download (.pdf) HEMATOLOGY Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Erythropoietinb (U/L) 4–27 12–25 8–67 14–222 7, 10, 47 Ferritinb (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 Haptoglobin (mg/mL) 25–250 130 ± 43 115 ± 50 135 ± 65 26A Hemoglobinb (g/dL) 12–15.8d 11.6–13.9 9.7–14.8 9.5–15.0 10, 45, 47, 58, 62 Hematocritb (%) 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 capacity (TIBC)b (μg/dL) 251–406 278–403 Not reported 359–609 62 Iron, serumb (μg/dL) 41–141 72–143 44–178 30–193 10, 62 Mean corpuscular hemoglobin (MCH) (pg/cell) 27–32 30–32 30–33 29–32 42 Mean corpuscular volume (MCV) (×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 (MPV) (μm3) 6.4–11.0 7.7–10.3 7.8–10.2 8.2–10.4 42 Red blood cell count (RBC) (×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 (RDW) (%) <14.5 12.5–14.1 13.4–13.6 12.7–15.3 42 White blood cell count (WBC) (×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) 200–400c 254–344 220–441 288–530 39, 42 Transferrin, saturation without iron (%) 22–46b Not reported 10–44 5–37 47 Transferrin, saturation with iron (%) 22–46b Not reported 18–92 9–98 47 COAGULATION Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Antithrombin III, functional (%) 70–130 89–114 78–126 82–116 15, 16, 39A D-Dimer (μg/mL) 0.22–0.74 0.05–0.95 0.32–1.29 0.13–1.7 16, 25, 25C, 35, 39A, 41A, 51 Factor V (%) 50–150 75–95 72–96 60–88 40 Factor VII (%) 50–150 100–146 95–153 149–2110 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) 233–496 244–510 291–538 301–696 16, 25, 25C, 39A, 41A, 42, 51 Fibronectin (mg/L) 290 ± 85 377 ± 309 315 ± 295 334 ± 257 27A Homocysteine (μmol/L) 4.4–10.8 3.34–11 2.0–26.9 3.2–21.4 43, 45, 46, 53, 72 International normalized ratio (INR) 0.9–1.04g 0.86–1.08 0.83–1.02 0.80–1.09 15, 41A Partial thromboplastin time, activated (aPTT) (sec) 26.3–39.4 23.0–38.9 22.9–38.1 22.6–35.0 15, 16, 41A, 42 Prothrombin time (PT) (sec) 12.7–15.4 9.7–13.5 9.5–13.4 9.6–12.9 16, 41A, 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 Thrombin time (TT) (sec) 17.7 ± 2.8 16.1 ± 1.5 15.4 ± 2.7 16.5 ± 2.4 27A Thrombomodulin (ng/mL) 2.7 ± 3.1 4.3 ± 1.3 4.2 ± 1.2 3.6 ± 1.3 27A Tissue plasminogen activator (ng/mL) 1.6–13h 1.8–6.0 2.36–6.6 3.34–9.20 15, 16, 25C Tissue plasminogen activator inhibitor-1 (ng/mL) 4–43 16–33 36–55 67–92 16, 25C von Willebrand disease von Willebrand factor antigen (%) 75–125 62–318 90–247 84–422 39A, 44A, 73 ADAMTS-13, von Willebrand cleaving protease (%) 40–170i 40–160 22–135 38–105 39A, 44A BLOOD CHEMICAL CONSTITUTENTS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Alanine aminotransferase (ALT) (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 Alpha-fetoprotein (ng/mL) — — ∼130–400 ∼130–590 39B Ammonia (μM) 31 ± 3.2 — — 27.3 ± 1.6 31A 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 aminotransferase (AST) (U/L) 12–38 3–23 3–33 4–32 5, 39, 42, 70 Bicarbonate (mmol/L) 22–30 20–24 20–24 20–24 42 Bilirubin, total (mg/dL) 0.3–1.3 0.1–0.4 0.1–0.8 0.1–1.1 5, 39 Bilirubin, unconjugated (mg/dL) 0.2–0.9 0.1–0.5 0.1–0.4 0.1–0.5 5, 42 Bilirubin, conjugated (mg/dL) 0.1–0.4 0–0.1 0–0.1 0–0.1 5 Bile acids (μmol/L) 0.3–4.8j 0–4.9 0–9.1 0–11.3 5, 14 CA-125 (μg/mL) 7.2–27 2.2–268 12–25.1 16.8–43.8 3A, 30A, 67A Calcium, ionized (mg/dL) 4.5–5.3 4.5–5.1 4.4–5.0 4.4–5.3 26, 42, 48, 56 Calcium, total (mg/dL) 8.7–10.2 8.8–10.6 8.2–9.0 8.2–9.7 3, 29, 39, 42, 48, 56, 63 Ceruloplasmin (mg/dL) 25–63 30–49 40–53 43–78 42, 44 Chloride (mEq/L) 102–109 101–105 97–109 97–109 20, 39, 42 Creatinine (mg/dL) 0.5–0.9d 0.4–0.7 0.4–0.8 0.4–0.9 39, 42, 45 Gamma-glutamyl transpeptidase (GGT) (U/L) 9–58 2–23 4–22 3–26 5, 42, 39, 70 Lactate dehydrogenase (U/L) 115–221 78–433 80–447 82–524 42, 29, 39, 70 Lipase (U/L) 3–43 21–76 26–100 41–112 32 Magnesium (mg/dL) 1.5–2.3 1.6–2.2 1.5–2.2 1.1–2.2 3, 26, 29, 39, 42, 48, 63 Osmolality (mOsm/kg H2O) 275–295 275–280 276–289 278–280 17, 63 Phosphate (mg/dL) 2.5–4.3 3.1–4.6 2.5–4.6 2.8–4.6 3, 26, 33, 39, 42 Potassium (mEq/L) 3.5–5.0 3.6–5.0 3.3–5.0 3.3–5.1 20, 26, 29, 39, 42, 63, 66 Prealbumin (mg/dL) 17–34 15–27 20–27 14–23 42 Protein, total (g/dL) 6.7–8.6 6.2–7.6 5.7–6.9 5.6–6.7 26, 29, 42 Sodium (mEq/L) 136–146 133–148 129–148 130–148 17, 26, 29, 39, 42, 63, 66 Urea nitrogen (mg/dL) 7–20 7–12 3–13 3–11 20, 39, 42 Uric acid (mg/dL) 2.5–5.6d 2.0–4.2 2.4–4.9 3.1–6.3 17, 39, 42 METABOLIC AND ENDOCRINE TESTS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Aldosterone (ng/dL) 2–9 6–104 9–104 15–101 21, 34, 69 Angiotensin-converting enzyme (ACE) (U/L) 9–67 1–38 1–36 1–39 20, 54 Cortisol (μg/dL) 0–25 7–19 10–42 12–50 42, 69 Hemoglobin A1C (%) 4–6 4–6 4–6 4–7 48, 49, 59 Parathyroid hormone (pg/mL) 8–51 10–15 18–25 9–26 3 Parathyroid hormone-related protein (pmol/L) <1.3e 0.7–0.9 1.8–2.2 2.5–2.8 3 Renin, plasma activity (ng/mL/hr) 0.3–9.0e Not reported 7.5–54.0 5.9–58.8 20, 34 Thyroid stimulating hormone (TSH) (μIU/mL) 0.34–4.25 0.60–3.40 0.37–3.60 0.38–4.04 39, 42, 57 Thyroxine-binding globulin (mg/dL) 1.3–3.0 1.8–3.2 2.8–4.0 2.6–4.2 42 Thyroxine, free (fT4) (ng/dL) 0.8–1.7 0.8–1.2 0.6–1.0 0.5–0.8 42, 57 Thyroxine, total (T4) (μg/dL) 5.4–11.7 6.5–10.1 7.5–10.3 6.3–9.7 29, 42 Triiodothyronine, free (fT3) (pg/mL) 2.4–4.2 4.1–4.4 4.0–4.2 Not reported 57 Triiodothyronine, total (T3) (ng/dL) 77–135 97–149 117–169 123–162 42 VITAMINS AND MINERALS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Copper (μg/dL) 70–140 112–199 165–221 130–240 2, 30, 42 Selenium (μg/L) 63–160 116–146 75–145 71–133 2, 42 Vitamin A (retinol) (μg/dL) 20–100 32–47 35–44 29–42 42 Vitamin B12 (pg/mL) 279–966 118–438 130–656 99–526 45, 72 Vitamin C (ascorbic acid) (mg/dL) 0.4–1.0 Not reported Not reported 0.9–1.3 64 Vitamin D, 1,25-dihydroxy (pg/mL) 25–45 20–65 72–160 60–119 3, 48 Vitamin D, 24,25-dihydroxy (ng/mL) 0.5–5.0e 1.2–1.8 1.1–1.5 0.7–0.9 60 Vitamin D, 25-hydroxy (ng/mL) 14–80 18–27 10–22 10–18 3, 60 Vitamin E (α-tocopherol) (μg/mL) 5–18 7–13 10–16 13–23 42 Zinc (μg/dL) 75–120 57–88 51–80 50–77 2, 42, 58 AUTOIMMUNE AND INFLAMMATORY MEDIATORS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References C3 complement (mg/dL) 83–177 62–98 73–103 77–111 42 C4 complement (mg/dL) 16–47 18–36 18–34 22–32 42 C-reactive protein (CRP) (mg/L) 0.2–3.0 Not reported 0.4–20.3 0.4–8.1 28 Erythrocyte sedimentation rate (ESR) (mm/hr) 0–20d 4–57 7–47 13–70 71 IgA (mg/dL) 70–350 95–243 99–237 112–250 42 IgG (mg/dL) 700–1700 981–1267 813–1131 678–990 42 IgM (mg/dL) 50–300 78–232 74–218 85–269 42 SEX HORMONES Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Dehydroepiandrosterone sulfate (DHEAS) (μmol/L) 1.3–6.8e 2.0–16.5 0.9–7.8 0.8–6.5 52 Estradiol (pg/mL) <20–443d,f 188–2497 1278–7192 6137–3460 13, 52 Progesterone (ng/mL) <1–20d 8–48 99–342 13, 52 Prolactin (ng/mL) 0–20d 36–213 110–330 137–372 3, 13, 38, 49 Sex hormone binding globulin (nmol/L) 18–114d 39–131 214–717 216–724 1, 52 Testosterone (ng/dL) 6–86d 25.7–211.4 34.3–242.9 62.9–308.6 52 17-Hydroxyprogesterone (nmol/L) 0.6–10.6d,e 5.2–28.5 5.2–28.5 15.5–84 52 LIPIDS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Cholesterol, total (mg/dL) <200 141–210 176–299 219–349 8, 18, 31, 42 HDL-cholesterol (mg/dL) 40–60 40–78 52–87 48–87 8, 18, 31, 42, 55 LDL-cholesterol (mg/dL) <100 60–153 77–184 101–224 8, 18, 31, 42, 55 VLDL-cholesterol (mg/dL) 6–40e 10–18 13–23 21–36 31 Triglycerides (mg/dL) <150 40–159 75–382 131–453 8, 18, 31, 39, 42, 55 Apolipoprotein A-I (mg/dL) 119–240 111–150 142–253 145–262 18, 39, 49 Apolipoprotein B (mg/dL) 52–163 58–81 66–188 85–238 18, 39, 49 CARDIAC Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Atrial natriuretic peptide (ANP) (pg/mL) Not reported Not reported 28.1–70.1 Not reported 11 B-type natriuretic peptide (BNP) (pg/mL) 22 ± 10 22 ± 10 32 ± 15 31 ± 21 12A Creatine kinase (U/L) 39–238d 27–83 25–75 13–101 41, 42 Creatine kinase-MB (U/L) <6k Not reported Not reported 1.8–2.4 41 NT-pro-BNP (pg/mL) 50 ± 26 60 ± 45 60 ± 40 43 ± 34 12A Troponin I (ng/mL) 0–0.08 Not reported Not reported 0–0.064(intrapartum) 36, 65 BLOOD GAS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Bicarbonate (HCO3−) (mEq/L) 22–26 Not reported Not reported 16–22 23 Pco2 (mm Hg) 38–42 Not reported Not reported 25–33 23 Po2 (mm Hg) 90–100 93–100 90–98 92–107 23, 67 pH 7.38–7.42(arterial) 7.36–7.52(venous) 7.40–7.52(venous) 7.41–7.53(venous)7.39–7.45(arterial) 23, 26 RENAL FUNCTION TESTS Nonpregnant Adulta 1st Trimester 2nd Trimester 3rd Trimester References Effective renal plasma flow (mL/min) 492–696d,e 696–985 612–1170 595–945 19, 22 Glomerular filtration rate (GFR) (mL/min) 106–132d 131–166 135–170 117–182 19, 22, 50 Filtration fraction (%) 16.9–24.7l 14.7–21.6 14.3–21.9 17.1–25.1 19, 22, 50 Osmolarity, urine (mOsm/kg) 500–800 326–975 278–1066 238–1034 61 24–hr albumin excretion (mg/24 hr) <30 5–15 4–18 3–22 27, 61 24–hr calcium excretion (mmol/24 hr) <7.5e 1.6–5.2 0.3–6.9 0.8–4.2 66 24–hr creatinine clearance (mL/min) 91–130 69–140 55–136 50–166 22, 66 24–hr creatinine excretion (mmol/24 hr) 8.8–14e 10.6–11.6 10.3–11.5 10.2–11.4 61 24–hr potassium excretion (mmol/24 hr) 25–100e 17–33 10–38 11–35 66 24–hr protein excretion (mg/24 hr) <150 19–141 47–186 46–185 27 24–hr sodium excretion (mmol/24 hr) 100–260e 53–215 34–213 37–149 17, 66 aUnless otherwise specified, all normal reference values are from the seventeenth edition of Harrison’s Principles of Internal Medicine (37).bRange includes references with and without iron supplementation.cReference values are from Laboratory Reference Handbook, Pathology Department, Parkland Hospital, 2005.dNormal reference range is specific range for females.eReference values are from the 15th edition of Harrison’s Principles of Internal Medicine (12).fRange is for premenopausal females and varies by menstrual cycle phase.gReference values are from Cerneca et al: Coagulation and fibrinolysis changes in normal pregnancy increased levels of procoagulants and reduced levels of inhibitors during pregnancy induce a hypercoagulable state, combined with a reactive fibrinolysis (15).hReference values are from Cerneca et al and Choi et al: Tissue plasminogen activator levels change with plasma fibrinogen concentrations during pregnancy (15, 16).iReference values are from Mannucci et al: Changes in health and disease of the metalloprotease that cleaves von Willebrand factor (44A).jReference values are from Bacq et al: Liver function tests in normal pregnancy: a prospective study of 102 pregnant women and 102 matched controls (5).kReference values are from Leiserowitz et al: Creatine kinase and its MB isoenzyme in the third trimester and the peripartum period (41).lReference values are from Dunlop: Serial changes in renal haemodynamics during normal human pregnancy (19).Appendix courtesy of Dr. Mina Abbassi-Ghanavati and Dr. Laura G. Greer.