Prophylactic antithrombotic regimen during subsequent pregnancies should also be individualized. The use of low molecular weight heparins is becoming more widespread. They have reliable pharmacokinetics, require less frequent injections than unfractionated heparin and carry a lower risk of treatment complications. LMW heparins are safe and effective and they are replacing UFH as the anticoagulant of choice during pregnancy. Both UFH and LMWH are not secreted into breast milk and can be safely given to nursing mothers. Warfarin does not induce an anticoagulant effect in the breast-fed infant, so it can be safely used in women who require postpartum anticoagulant therapy.

In order to evaluate the level of platelet activation in patients with the high risk for developing the thromboembolic complications and influence of isometric exercise on this process, the estimations of platelet factor 4 (PF 4) by the radioimmunoassay have been done in 20 diabetic patients. The half of examined patients had the diabetic microangiopathy as well as macroangiopathy (subgroup A) and the other half (subgroup B) had no clinical sign of macroangipathy. The control group comprises 10 healthy volunteers. The estimations of PF 4 have been done at rest and af ter 2 minutes isometric exercise. The mean values of PF 4 in both subgroups at the rest were significantly elevated in relation to the values in control group (sbg A = 92,7 ng/ml, sbg B = 44,05 ng/ml and control 7,91 ng/ml). After the isometric exercise the mean values of PF 4 in diabetics have been moderately decreased (sbg A = 69,01 ng/ml, sbg B = 39,2 ng/ml), but increase in relation to mean values in control group (24,2 ng/ml). The results indicate the high degree of in vivo platelet activation in diabetic patients, especially in those with macroangiopathic changes. The isometric exercise in the mean time, did not effect the platelet release reaction in examined patients.

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In 38 patients with deep venous thrombosis and 52 patients with myocardial infarction who were on long term anticoagulant therapy, the estimations of β-TG have been done by radioimmunoassay using a kit developed by the Radiochemical Centre, Amersham, England. In the group of patients with deep venous thrombosis, the increased values of β-TG /values which were higher than 80 ng/ml /have been established in 47,3% of the cases and among the patients with myocardial infarction, in 73% of the cases. From the total of 56 patients with increased level of β-TG, in 50 patients the level of prothrombin activity was higher than 20%. On the other hand, in patients with normal concentration of β-TG, the level of prothrombin activity was usually lower than 20%. Our preliminary results suggest the possible use of estimation of β-TG as an important supplementary parameter for evaluation of a substantial efficasy of applied anticoagulant therapy.