Adaptive capabilities of the hemocoagulation system in pregnant women who had complications from the group of major obstetric syndromes

Abstract

Aim - to evaluate the adaptive capabilities of the hemocoagulation system in pregnant women who had complications from the group of major obstetric syndromes (MOS) for the further development of an algorithm for the prevention of this complication.

Materials and methods. The main study group (MG) - 99 pregnant women who had a complication from the group of MOS, which was clinically manifested by placental insufficiency; control group (CG) - 50 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. The concentration of fibrinogen (Fg), fibrin/fibrinogen degradation products (PDFF), activated recalcification time (ART), activated partial thromboplastin time (APTT), calculation of the prothrombin index (PTI), and thromboelastography (TEG) were determined. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistical 6.0 programs, differences at p<0.05 were considered statistically significant.

Results. In the І trimester of pregnancy, the concentration of Fg in the blood plasma of MG pregnant women was 2.62±0.32 g/l against 2.94±0.23 g/l in CG pregnant women, in the II trimester 2.76±0.34 g/l versus 3.24±0.28 g/l, in the III trimester - 2.87±0.29 g/l versus 4.18±0.22 g/l, respectively (р<0.05). The average value of APT in pregnant MG was lower in the I trimester by 23.0%, in the II trimester by 40.0%, and in the III trimester by 17.0% (p<0.05). At the beginning of gestation, the MG showed a lengthening of the APT - 74.6±3.4 s against 64.2±4.3 s in CG in the I trimester of pregnancy against the background of a moderate decrease in APTT. In the first trimester of pregnancy, the concentration of PDFF in МG was 6.8±0.08×10 g/l against 1.8±0.02×10 g/l in CG, in the second trimester - 9.4±0.17×10 g/l against 2, 4±0.17×10 g/l, in the III trimester - 11.6±0.27×10 g/l versus 4.2±0.31×10 g/l, respectively (p<0.05).

Conclusions. The presence of dysregulatory changes in the hemocoagulation system, in particular in its endothelial-platelet link, and an increase in the total coagulation potential of blood, is characterized by an increase in the index of thrombodynamic potential, a relative prolongation of the AChR against the background of a moderate reduction in AChT, an increase in the concentration of PDFF, thromboxane and its metabolic products, a violation of the balance between PgI₂ and T×A₂, which in general is a sign of the subclinical course of the chronic form of disseminated internal coagulation syndrome, which leads to the early development of perfusion disorders in the mother-placenta-fetus system.

The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. The informed consent of the patient was obtained for conducting the studies.

The author is stating no conflict of interests is declared.