Longitudinal evaluation of markers of hemostasis in pregnancy

Abstract

Abstract:Objective: The aim of this study was to establish the physiologic changes in hemostasis during pregnancy and to fi nd the association between the factor V Leiden mutation and adverse pregnancy outcome. Methods: We investigated blood samples of 148 pregnant women during each trimester of pregnancy. We measured their serum concentrations of factors I, II, V, VII, VIII, IX, X, XI, XII, D-dimers, prothrombin time, INR, aPTT, activity of protein C and S, antithrombin III and platelet count. The pregnancy outcome of women with factor V Leiden mutation was compared to those without congenital thrombophilia. Results: Prothrombin time, INR and aPTT were signifi cantly shorter. We found signifi cantly higher plasma concentrations of fi brinogen and d-dimers and higher levels of activity of factor VII and X in the third trimester. No signifi cant difference was found in protein C and antithrombin III activity. The protein S activity was lower in the second trimester and it increased in the third trimester. Although most of the clotting factors were rising during the pregnancy, there was no evidence of fi brinolytic overactivation. In our study, the carriership of factor V Leiden mutation did not affect the incidence of preeclampsia, eclampsia, intrauterine fetal death and venous thromboembolism. Placental abruption was rare. Conclusion: Hemostatic changes in pregnancy are signifi cant and essential, and have the potential to cause adverse pregnancy outcome. In addition, hypercoagulable state during pregnancy is considered to be physiological (Tab. 4, Ref. 36). Text in PDF www.elis.sk.

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

“…Similarly, lower vitamin D status during gestation may be associated with cardiovascular disease risk later in life [ 305 ]. Serum concentrations of factors I, II, V, VII, VIII, IX, X, XI, and XII, D-dimers, prothrombin time, INR, aPTT, activity of proteins C and S, antithrombin III, and platelet count are used to evaluate hemostasis in pregnancy [ 132 ]. STIM1 plays an essential role in normal cardiac function, mainly homeostasis in the adult heart, which may be important for the regulation of ER and mitochondrial function [ 133 ] ( Table 2 ).…”

Reference Intervals of Routine Coagulation Assays During the Pregnancy and Puerperium Period

“…However, levels of coagulation factors VII, VIII, IX, fibrinogen (Fib. ), and D-dimer increased markedly (5,6). In another study, PT, APTT, and thrombin time (TT) were decreased significantly, but Fib.…”

Global assays of hemostasis in the diagnostics of hypercoagulation and evaluation of thrombosis risk

“…Probably that is why APTT has no predictive value as a thrombosis risk marker following surgery [ 59 , 60 ], trauma [ 61 ], diabetes [ 55 , 62 ], cancer [ 63 ]. Data about pregnancy are contradictive [ 64 , 65 ]. The main hypercoagulation factor detected by APTT shortening is most likely increased concentration or activity of coagulation factor predecessors.…”