REFERENCE INTERVALS FOR HEMOSTASIOLOGICAL LABORATORY TESTS DURING PHYSIOLOGICAL PREGNANCY


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Objective. To generate reference intervals for hemostasiological tests in relation to the period of physiological pregnancy. Subjects and methods. A total of828 women with uncomplicated singleton pregnancy were examined. The patients were divided into 6 subgroups in accordance with the gestational age (4-8, 9-13, 14-20, 21-27, 28-34, and 35-40 weeks). Eight most common hemostasiological laboratory tests, such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), the activity of antithrombin III (ATIII) and protein C, and the concentration of fibrinogen, D-dimer, and von Willebrand factor (vWF), were investigated. 2.5th and 97.5th percentile values were calculated for these indicators according to the International Federation of Clinical Chemistry (IFCC) guidelines for the statistical processing of references values. Results. Reference intervals were obtained for PT, APTT, TT, fibrinogen, vWF, D-dimer, ATIII, and protein C in these periods of pregnancy. There were changes in most tests as compared to those obtained in a control group of nonpregnant women (p < 0.05). Conclusion. Special reference intervals must be used to assess the results of coagulation tests in pregnant women. The findings may be employed in other clinical and diagnostic laboratories after appropriate validation in accordance with the requirements of the Clinical and Laboratory Standards Institute (CLSI).

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Sobre autores

Tatiana Ivanets

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: t_ivanets@oparina4.ru
PhD., Head of the Scientific Diagnostical Laboratory Moscow 117997, Ac. Oparina str. 4, Russia

Mariya Vinogradova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: m_vinogradova@oparina4.ru
PhD., Head of Reproductive Hematology and Clinical Hemostasiology Department Moscow 117997, Ac. Oparina str. 4, Russia

Nataliya Dolgushina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: n_dolgushina@oparina4.ru
M.D., Ph.D., M.P.H., Head of R&D Department Moscow 117997, Ac. Oparina str. 4, Russia

Bibliografia

  1. Franchini M. Haemostasis and pregnancy. Thromb. Haemost. 2006; 95(3): 401-13.
  2. Ramsay M. Normal values. In: James D.K., Steer P.J., Weiner C.R., Gonik B. High risk pregnancy. Management options. 4th ed. Saunders; 2011.
  3. Concordet D., Geffré A., Braun J.P., Trumel C. A new approach for the determination of reference intervals from hospital-based data. Clin. Chim. Acta. 2009; 405(1-2): 43-8.
  4. Grasbeck R. Референсные значения: развитие концепции. Лабораторная медицина. 2011; 11: 79-83.
  5. Gronowski A.M., ed. Handbook of clinical laboratory testing during pregnancy. New Jersey: Humana Press Inc.; 2004.
  6. Liu J., Yuan E., Lee L. Gestational age-specific reference intervals for routine haemostatic assays during normal pregnancy. Clin. Chim. Acta. 2012; 413(1-2): 258-61.
  7. Szecsi P.B., Jorgensen M., Klajnbard A., Andersen M.R., Colov N.P., Stender S. Haemostatic reference intervals in pregnancy. Thromb. Haemost. 2010; 103(4): 718-27.
  8. Kovac M., Mikovic Z., Rakicevic L., Srzentic S., Mandic V., Djordjevic V. et al. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2010; 148(1): 27-30.
  9. Réger B., Péterfalvi A., Litter I., Pótó L., Mózes R., Tóth O. et al. Challenges in the evaluation of D-dimer and fibrinogen levels in pregnant women. Thromb. Res. 2013; 131(4): e183-7.
  10. Mahieu B., Jacobs N., Mahieu S., Naelaerts K., Vertessen F., Weyler J. et al. Haemostatic changes and acquired activated protein C resistance in normal pregnancy. Blood Coagul. Fibrinolysis. 2007; 18(7): 685-8.
  11. Clark P. Changes of hemostasis variables during pregnancy. Semin. Vasc. Med. 2003; 3(1): 13-24.
  12. Gatti L., Tenconi P.M., Guarneri D., Bertulessi C., Ossola M.W., Bosco P., Gianotti G.A. Hemostatic parameters and platelet activation by flow-cytometry in normal pregnancy: a longitudinal study. Int. J. Clin. Lab. Res. 1994; 24(4): 217-9.
  13. Uchikova E.H., Ledjev I.I. Changes in haemostasis during normal pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2005; 119(2): 185-8.
  14. Abbassi-Ghanavati M., Greer L.G. Reference table of normal laboratory lalues in uncomplicated pregnancies. In: Cunningham F.G., Leveno K.J., Bloom S., Hauth J.C., Rouse D.J., Spong C.Y., eds. Williams obstetrics. 23rd ed. New York: McGraw-Hill; 2010.
  15. Horowitz G.L., Altaie S., Boyd J.C., Ceriotti F., Gard U., Horn P. et al. Defining, establishing and verifying reference intervals in the clinical laboratory: C28-A3 Approved Guideline. 3rd ed. Pennsylvania, USA: Clinical and Laboratory Standards Institute; 2010.
  16. Solberg H.E., Stamm D. International Federation of Clinical Chemistry IFCC. IFCC recommendation: theory of reference values: Part 4. Control of analytical variation in the production, transfer and application of reference values. Clin. Chim. Acta. 1991; 202(1-2): S5-10.
  17. Solberg H.E. Establishment and use of reference values. In: Burtis C.A., Ashwood E.R., eds. Tietz textbook of clinical chemistry. Philadephia: W.B. Saunders; 1999: 454-84.
  18. Solberg H.E. The IFCC recommendation on estimation of reference intervals. The RefVal program. Clin. Chem. Lab. Med. 2004; 42(7): 710-4.
  19. The National Committee for Clinical Laboratory standards. How to define and determine reference intervals in the clinical laboratory; Approved guideline. 2nd ed. Pennsylvania: NCCLS; 2000.
  20. Harris E.K., Boyd J.C. On dividing reference data into subgroups to produce separate reference ranges. Clin. Chem. 1990; 36(2): 265-9.
  21. Clifford S.M., Bunker A.M., Jacobsen J.R., Roberts W.L. Age and gender specific pediatric reference intervals for aldolase, amylase, ceruloplasmin, creatine kinase, pancreatic amylase, prealbumin and uric acid. Clin. Chim. Acta. 2011; 412(9-10): 788-90.
  22. Walton R.M. Establishing reference intervals: health as a relative concept. J. Exotic Pet Med. 2001; 10(2): 66-71.
  23. Wang M., Lu S., Li S., Shen F. Reference intervals of D-dimer during the pregnancy and puerperium period on the STA-R evolution coagulation analyzer. Clin. Chim. Acta. 2013; 425: 176-80.

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