Is there a tendency for thrombosis in gestational diabetes mellitus?

Gorar, Suheyla; Alioglu, Bulent; Ademoglu, Esra Nur; Uyar, Seyit; Bekdemir, Handan; Candan, Zehra; Saglam, Beylan; Culha, Cavit; Aral, Yalcin

doi:10.1530/endoabs.41.ep524

Cited by 14 publications

(22 citation statements)

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“…For example, prior studies included women with gestational diabetes mellitus, despite the tendency to develop thrombosis in this condition. 23 Patients are at increased risk of bleeding when anaemic and studies have shown a hypercoagulable appearance in thromboelastography and ROTEM®. One study analysed platelet function in anaemic blood and accelerated platelet aggregation was demonstrated at lower haemoglobin concentrations.…”

Section: Discussionmentioning

confidence: 99%

Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia

Lee

Eley

Wyssusek

et al. 2019

International Journal of Obstetric Anesthesia

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Queensland (SERC) provided funding for ROTEM® testing and consumables; National Blood Authority Australia, Australian Society of Anaesthetists, and The RBWH and RBWH Foundation provided funding for research nursing support and time to conduct the research. None of these organisations had any involvement in the study design, data collection, analysis interpretation of data or the writing of this report. Conflicts: The authors report no conflicts of interest This study was conducted at The Royal Brisbane and Women's Hospital (RBWH).

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Section: Discussionmentioning

confidence: 99%

Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia

Lee

Eley

Wyssusek

et al. 2019

International Journal of Obstetric Anesthesia

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“…Furthermore, PT and APTT, measured between the 20th and 24th gestational weeks, were significantly lower in patients with GDM than in healthy people [29] . In another study, the mean APTTs of non-diabetic, treated, and untreated type 2 diabetic patients were 32.8 ± 4.12 sec, 34.4 ± 5.3 sec, and 25.4 ±8.5 sec, respectively, which showed that APTT was lower in diabetic patients and that this defect was normalized by diabetes treatment [31] .…”

Section: Discussionmentioning

confidence: 80%

“…FIB is one of the conventional measures of coagulability during the perinatal period, as well as being a biomarker of inflammation, and is a complex glycoprotein synthesized by hepatocytes [28] . FIB increases during normal pregnancies, but also in pregnancy-related complications such as GDM [29,30] , reaching significantly higher values in patients with GDM than those in healthy pregnant women [24,30] . In the present study, FIB was also higher in GDM patients than that in the NGDM group, confirming a tendency towards hypercoagulability in the former.…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Liu

Sun

Tao

et al. 2019

Preprint

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Background: To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/fibrinolysis abnormality in antenatal Chinese women. Methods: Case control study. Fifty women had GDM and 132 did not (the NGDM group) grouping by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Maternal plasma biochemistry and previous medical history were collected from perinatal health records. Antenatal coagulation/fibrinolysis activity(CFA) parameters was assessed using thromboelastography and routine CFA parameters respectively. Univariate and multiple regression analyses were used to evaluate the associations between GDM and CFA parameters. Results: The women with GDM were significantly older than those without GDM (30.3 vs. 28.6 years, P=0.012). Compared with the NGDM group, the GDM group had a significantly higher prevalence of cesarean delivery (56.0% vs. 37.9%, P=0.027) and higher values of fibrinogen (FIB) (4.7vs. 4.3 g/L P=0.001), activated partial thromboplastin time (APTT) (30.9 vs. 29.5 seconds P=0.010).There were no significant differences in the prevalence of maternal thrombotic events or neonatal events.GDM was significantly associated with higher APTT (β 1.41seconds, 95% CI 0.29–2.53), FIB (β 0.38g/L, 95% CI 0.14–0.61), and percentage reduction in clot lysis after 30 min(LY30)(β 1.14%, 95% CI 0.15–2.13) after adjustment for potential confounding factors. Conclusions: GDM is significantly associated with hypercoagulability and secondary hyperfibrinolysis in these antenatal Chinese women.

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“…When it is combined with maternal hyperglycemia (prothrombotic tendency) and hypercoiling of the cord (thereby causing vascular stasis and ischemia), it results in thrombosis in the foetal vascular tree, leading to foetal growth restriction and increased perinatal mortality and morbidity. 25,26 The following findings were seen as part of FVM in our study population: chorionic plate/ stem villous vessel thrombi, vascular ectasia, groups of avascular, fibrotic to hyalinized villi and villous stromal karyorrhexis.…”

Section: Derangements In Foetoplacental Circulation/foetal Vascular Mmentioning

confidence: 73%

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

Natarajan

Umamaheswari

2019

Int J Reprod Contracept Obstet Gynecol

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Background: To evaluate the placental morphology and perinatal outcome in patients with gestational hyperglycemia on diet and medication.Methods: Placental examinations performed at the Department of Pathology between August 2016 to August 2018 were retrospectively reviewed. Of the received 140 placentas, 35 of gestational diabetes (GDM) and pre gestational diabetes were identified and segregated into hyperglycemia on diet and on medication. The clinical details, placental findings and perinatal outcome of patients in both the groups (gestational hyperglycemia on diet and medication) were collected and analyzed.Results: Among the 35 cases, there were 24 cases of mild gestational hyperglycemia controlled with diet and 11 cases of hyperglycemia on medication (oral hypoglycemic drugs ± insulin).Most of the placentae in both the groups weighed less than tenth centile. The cord abnormalities such as hyper coiling, velamentous /marginal insertion and furcate cord were observed more in women with GDM on diet. There was no significant gross placental lesion in those on medication. Placental histological features most consistently associated with both the groups include, disturbances of villous maturation (DVM), Derangements in uteroplacental / foetoplacental circulation and villous capillary lesions. Small for gestational age and intrauterine foetal death were found in both the groups, but more commonly in patients with hyperglycemia on medication.Conclusions: Villous maturation defects, uteroplacental / foetoplacental malperfusion are the essential placental changes which can result in adverse perinatal outcomes in women with hyperglycemia irrespective of the diabetic control.

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Is there a tendency for thrombosis in gestational diabetes mellitus?

Cited by 14 publications

References 0 publications

Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia

Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

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