Reference ranges for von Willebrand factor and ADAMTS-13 metalloproteinase levels and activity and platelet activity in physiological pregnancy


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Abstract

Objective. To establish allowable ranges for platelet aggregation and von Willebrand factor (vWF) and ADAMTS-13 metalloproteinase activity and levels in physiological pregnancy. Subject and methods. Examinations were performed in 301 females who were nonpregnant or physiologically pregnant at different stages and 2-3 days after spontaneous labor. Aggregatometry and enzyme immunoassay were used to study platelet function and vWF and ADAMTS-13 levels and activity. Results. The pregnant women showed an increased platelet susceptibility to ADP (0.1 μΜ), which was associated with 1.19 and 1.42-fold vWF ristocetin cofactor activity increases relative to the baseline values at 22-24 and 34-36 weeks’ gestation, respectively. The most noticeable change in vWF antigen levels was observed at 12-13 weeks’ gestation. The levels of the activity and antigen of ADAMTS-13 at 6 to 13 weeks’ gestation were similar to those in the nonpregnant women. Subsequently, at 22 weeks to late periods of pregnancy, there was a decrease in this enzyme - in its activity and antigen by 26.4-39.2 and 28.7-31.7%, respectively, as compared to those seen in the nonpregnant women. The investigations indicated that in physiological pregnancy and postpartum, the Spearman correlation coefficient between the activities of vWF and the enzyme ADAMTS-13 was -27 (P < 0.001) and that between the antigens of vWF and ADAMTS-13 was equal to -0.32 (P < 0.001). Conclusion. There was a progressive increase in vWF activity and levels (at 12-13 weeks of physiological pregnancy) along with decreases in ADAMTS-13 activity and levels. The given data specify the mechanisms of platelet activation and may be used as estimated values while studying the hemostatic system in pregnant women and forming groups at risk for bleeding and thrombosis.

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About the authors

Andrey Pavlovich Momot

Altai Branch, Hematology Research Center, Ministry of Health of Russia; Altai State Medical University, Ministry of Health of Russia

Email: xyzan@yandex.ru
MD, Professor, Director

Petr Aleksandrovich Kiryushchenkov

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: kirulab@gmail.com
MD, Head of the Clinical Hamostasis Unit

Dina Anatolyevna Trukhina

Territorial Clinical Hospital, Ministry of Health of Russia

Email: nina-dina@nm.ru
the medical doctor of clinical hemostasis pathology lab

Irina Alekseyevna Taranenko

Altai Branch, Hematology Research Center, Ministry of Health of Russia; Altai State Medical University, Ministry of Health of Russia

Email: tarania@mail.ru
the Candidate of Medicine, senior research fellow

Olga Pavlovna Tomilina

Altai State Medical University, Ministry of Health of Russia; Territorial Clinical Hospital, Ministry of Health of Russia

Email: tomilina.o@inbox.ru
haematologist

Marina Viktorovna Pykhteeva

Territorial Clinical Hospital, Ministry of Health of Russia

Email: marina.marivip@yandex.ru
medical biologist of the hemostasis pathology lab

Natalya Ilyinichna Fadeeva

Altai State Medical University, Ministry of Health of Russia

Email: nat2fad@hotmail.com
MD, Professor, head

Lyudmila Petrovna Tsyvkina

Altai Branch, Hematology Research Center, Ministry of Health of Russia; Altai State Medical University, Ministry of Health of Russia

Email: katerina-cyvkina@mail.ru
MD, Professor, senior research fellow

Galina Valentinovna Serdyuk

Altai Branch, Hematology Research Center, Ministry of Health of Russia; Altai State Medical University, Ministry of Health of Russia

Email: gvser@mail.ru
MD, senior research fellow

Dmitriy Yevgenyevich Belozerov

Territorial Clinical Hospital, Ministry of Health of Russia

Email: dmitrbelozerov@yandex.ru
the medical doctor of clinical hemostasis pathology lab

Vyacheslav Vitalyevich Romanov

OOO "Invitro-Sibir"

Email: vvromanov@invitro.ru
the Candidate of Medicine, laboratory chief Novosibirsk

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