Immunological testing for platelet functional activity in gestational thrombocytopenia


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Abstract

Aim. To investigate the value of immunological testing for platelet functional activity in patients with gestational thrombocytopenia in the setting of hemostatic system activation. Materials and methods. This multicenter prospective study involved 299pregnant women in the third trimester of pregnancy divided into the study group (n=249), including patients with thrombocytopenia and the control group (n=50) comprised of women with a healthy pregnancy and normal platelet counts. We used flow cytometry with FITC- and PE-labeled antibodies against GP Ilb/IIIa receptors and P-selectin to determine the number of GP IIb/IIIa receptors and P-selectin expression on the platelet surface and conducted an association with the principle of ADP activation, which is used in standard induced aggregation. Results. After ADP activation, the study group patients with thrombocytopenia had almost 40-fold higher P-selectin expression and significantly higher number of GP IIb/IIIa receptors on the platelet surface than women in the control group (p=0.0001; p=0.001). This indicates platelet hyper-aggregation, hemostatic system activation and suggests the feasibility of using acetylsalicylic-acid- containing drugs and low molecular weight heparins in this specific patient category to prevent obstetric complications. Conclusion. The flow cytometry can be used as a new laboratory criterion for assessing platelet hyper-aggregation in pregnant women with thrombocytopenia. The findings also support the administration of acetylsalicylic acid and low molecular weight heparins in this patient category.

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About the authors

Olga L. Mysik

V.F. Snegirev Maternity Hospital № 6

Email: olga_mysik88@mail.ru
obstetrician-gynecologist

Marina S. Zainulina

V.F. Snegirev Maternity Hospital № 6; I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: zainulina@yandex.ru
Dr. Med. Sci., Professor of the Department of Obstetrics, Gynecology and Reproductology

Vladislav S. Baranov

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Email: baranov@vb2475.spb.edu
Dr. Med. Sci., Professor, Corresponding Member of RAS, Honored Scientist of the Russian Federation, Head of the Laboratory for Prenatal Diagnostics of Congenital and Hereditary Diseases

Aleksey S. Polyakov

S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: doctorpolyakov@gmail.com
Cand. Med. Sci., Head of the Hematology Department of the Clinic of the Department of Faculty Therapy named after S.P. Botkin

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