Eighty-six women admitted for evaluation of preeclampsia had plasma and urine screened for the presence of fibrin D-dimer using the monoclonal antibody DD-3B6 in a latex fixation assay (Dimertest). In 53 of the women screened, results were negative for fibrin D-dimer in both plasma and urine; in 33, results were positive in urine (N = 11), plasma (N = 14), or both (N = 8). D-dimer positive women were at increased risk for earlier delivery (mean 34 versus 36 weeks), lower birth weight babies (mean 2,327 versus 2,669 g), higher mean arterial pressures (mean 104 versus 94mm Hg), liver function test abnormalities (mean lactate dehydrogenase value 256 versus 142 U/L, mean serum glutamic-oxaloacetic transaminase 67 versus 23 U/L), and significantly elevated levels (> 40 micrograms/mL) of fibrin(ogen) degradation products (FDPs). Interestingly, 22 of 33 D-dimer positive women had insignificant levels of FDPs. Generally, D-dimer negative women had no significant abnormalities in results of coagulation tests and liver function tests. This study confirms previous observations on the value of D-dimer detection in screening for preeclampsia coagulopathy and extends this tool to its detection in urine.