INCREASED THROMBIN GENERATION AS A POTENTIAL MARKER FOR ADVERSE PREGNANCY OUTCOMES


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim. To estimate the effectiveness of the thrombin generation assay (TGA) in identifying high thrombogenic risk in pregnant women. Material and methods. The study comprised 30 healthy non-pregnant women (control group) and 32 women in the third trimester of pregnancy. Of the latter group, 22 women with complicated pregnancy comprised the study group while the remaining ten women made up the comparison group. After delivery, the patients in the study group were divided into subgroups with a favorable (n = 15) and adverse (n = 7) pregnancy outcomes. The state of the hemostatic system was examined using standard coagulation tests and TGA. Results. Thrombin generation assessed as endogenous thrombin potential (ETP), was statistically significantly higher in pregnant than in non-pregnant women (2300 ± 400 vs. 1700 ± 400, respectively, p <0.005). The patients with adverse pregnancy outcomes had statistically significantly higher ETP compared with women with favorable outcomes (2700 ± 600 vs. 2300 ± 300, respectively, p <0.005). Conclusion. TGA can be used to predict adverse pregnancy outcomes. Elevated ETP is associated with adverse pregnancy outcomes.

Full Text

Restricted Access

About the authors

Irina Vladimirovna Gribkova

Center for Clinical Research and Health Technology Assessment of the Moscow Health Department

Email: igribkova@yandex.ru
Ph.D.(bio.sci.), Leading Researcher at the Scientific and Clinical Department 121096, Russia, Moscow, ul. Minskaya, 12, build. 2

Natal'ya Sergeevna Koroleva

I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: tashakoroleva@gmail.com
Ph.D. Student at the Department of Obstetrics and Gynecology No 1 119991, Russia, Moscow, ul. Bolshaya Pirogovskaya, 2, page 4

M. V Davydovskaya

Center for Clinical Research and Health Technology Assessment of the Moscow Health Department; N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia

Email: mdavydovskaya@gmail.com
Dr.Med.Sci., Deputy Director for Research 121096, Russia, Moscow, ul. Minskaya, 12, build. 2

Andrei Vladimirovich Murashko

I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: murashkoa@mail.ru
Professor at the Department of Obstetrics and Gynecology No. 1 119991, Russia, Moscow, ul. Bolshaya Pirogovskaya, 2, page 4

References

  1. Бицадзе В.О., Макацария А.Д., Хизроева Д.Х., Макацария Н.А., Яшенина Е.В., Казакова Л.А. Тромбофилия как важнейшее звено патогенеза осложнений беременности. Практическая медицина. 2012; 9: 24-31.
  2. Mastrolia S.A., Mazor M., Loverro G., Klaitman V., Erez O. Placental vascular pathology and increased thrombin generation as mechanisms of disease in obstetrical syndromes. PeerJ. 2014; 2: e653.
  3. Simcox L.E., Ormesher L., Tower C., Greer I.A. Thrombophilia and pregnancy complications. Int. J. Mol. Sci. 2015; 16(12): 28418-28.
  4. Bates S.M. Preventing thrombophilia-related complications of pregnancy: an update. Expert Rev. Hematol. 2013; 6(3): 287-300.
  5. Липец Е.Н., Атауллаханов Ф.И., Пантелеев М.А. Интегральные лабораторные тесты гемостаза в диагностике гиперкоагуляции и оценке риска тромбоза. Онкогематология. 2015; 10(3): 73-91.
  6. Othman M., Falcon B.J., Kadir R. Global hemostasis in pregnancy: are we using thromboelastography to its full potential? Semin. Thromb. Hemost. 2010; 36(7): 738-46.
  7. Момот А.П., Молчанова И.В., Семенова Н.А., Романов В.В., Сердюк Г.В., Белозеров Д.Е., Трухина Д.А., Кудинова И.Ю., Максимова Н.В. Динамика показателей системы гемостаза у женщин при вынашивании беременности и после родов. Лабораторная служба. 2015; 4(2): 3-11.
  8. Patel J.P., Patel R.K., Roberts L.N., Marsh M.S., Green B., Davies J.G., Arya R. Changes in thrombin generation and D-dimer concentrations in women injecting enoxaparin during pregnancy and the puerperium. BMC Pregnancy Childbirth. 2014; 14: 384.
  9. Николаева А.Е., Кутуева Ф.Р., Кайка И.А., Папаян Л.П., Капустин С.И., Наместников Ю.А., Силина Н.Н. Клиническое значение ретрохориальной гематомы у беременных, имеющих факторы риска по возникновению репродуктивных потерь. Опыт ведения в условиях женской консультации. Акушерство и гинекология. 2011; 5: 94-8.
  10. Hemker H.C., Giesen P., AlDieri R., Regnault V., de Smed E, Wagenvoord R. et al. The calibrated automated thrombogram (CAT): a universal routine test for hyper- and hypocoagulability. Pathophysiol. Haemost. Thromb. 2002; 32(5-6): 249-53.
  11. Gribkova I.V., Lipets E.N., Rekhtina I.G., Bernakevich A.I., Ayusheev D.B., Ovsepyan R.A. et al. The modification of the thrombin generation test for the clinical assessment of dabigatran etexilate efficiency. Sci. Rep. 2016; 6: 29242.
  12. McLean K.C., Bernstein I.M., Brummel-Ziedins K.E. Tissue factor-dependent thrombin generation across pregnancy. Am. J. Obstet. Gynecol. 2012; 207(2): 135. e1-6.
  13. Erez O., Romero R., Vaisbuch E., Kusanovic J.P., Mazaki-Tovi S., Chaiworapongsa T. et al. The pattern and magnitude of “in vivo thrombin generation” differ in women with preeclampsia and in those with SGA fetuses without preeclampsia. J. Matern. Fetal Neonatal Med. 2018; 31(13): 1671-80.
  14. Rosenkranz A., Hiden M., Leschnik B., Weiss E.C., Schlembach D., Lang U. et al. Calibrated automated thrombin generation in normal uncomplicated pregnancy. Thromb. Haemost. 2008; 99(2): 331-7.
  15. Kovac M.K., Lalic-Cosic S.Z., Dmitrovic J.M., Djordjevic V.J., Radojkovic D.P. Thrombin generation, D-dimer and protein S in uncomplicated pregnancy. Clin. Chem. Lab. Med. 2015; 53(12): 1975-9.
  16. Joly B., Barbay V., Borg J.Y., Le Cam-Duchez V. Comparison of markers of coagulation activation and thrombin generation test in uncomplicated pregnancies. Thromb. Res. 2013; 132(3): 386-91.
  17. Bagot C.N., Leishman E., Onyiaodike C.C., Jordan F., Freeman D.J. Normal pregnancy is associated with an increase in thrombin generation from the very early stages of the first trimester. Thromb. Res. 2017; 157: 49-54.
  18. Efthymiou M., Lawrie A.S., Mackie I., Arachchillage D., Lane P.J., Machin S. et al. Thrombin generation and factor X assays for the assessment of warfarin anticoagulation in thrombotic antiphospholipid syndrome. Thromb. Res. 2015; 135(6): 1191-7.
  19. Vidaeff A.C., Mongan M., Ramin S.M., Saade G., Sangi-HaghpeykarH. Is thrombin activation predictive of subsequent preterm delivery? Am. J. Obstet. Gynecol. 2013; 208: 306. e1-7.
  20. Chowdary P., Adamidou D., Riddell A., Aghighi S., Griffioen A., Priest P. et al. Thrombin generation assay identifies individual variability in responses to low molecular weight heparin in pregnancy: implications for anticoagulant monitoring. Br. J. Haematol. 2015; 168(5): 719-27.
  21. Bennett S.A., Bagot C.N., Appiah A., Johns J., Ross J., Roberts L.N. et al. Women with unexplained recurrent pregnancy loss do not have evidence of an underlying prothrombotic state: experience with calibrated automated thrombography and rotational thromboelastometry. Thromb. Res. 2014; 133(5): 892-9.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2018 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies