Placental insufficiency and preeclampsia are associated with increased thrombin generation

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Abstract


Introduction. An urgent problem of modern medicine is the risk of thrombosis in women during pregnancy, which can cause complications in both the mother and the fetus. Currently, a relationship between thrombosis and pregnancy complications is shown. However, there are practically no studies comparing the state of the hemostatic system in women with various pathologies of pregnancy.

Purpose of the study — compare the status of the hemostatic system in pregnant women with various pregnancy complications.

Material and methods. 32 pregnant women in the 3rd trimester were examined. All women were divided into groups with various complications of pregnancy: venous insufficiency (n = 7), thrombophilia (n = 11), placental insufficiency + preeclampsia (n = 4). The comparison group included women with a physiological course of pregnancy (n = 10). In the study groups pregnant women received low molecular weight heparin (LMWH). Women from the comparison group did not receive any anticoagulant therapy. A study of the status of the hemostasis system was performed using standard coagulation tests and the thrombin generation test (TGT).

Results. The indicators of the standard coagulogram for each group were within the reference values. No statistically significant differences between the groups were detected for any indicator (paired Student’s t-test, ANOVA, p > 0.05). A statistically significant increase in the parameter of TGT: endogenous thrombin potential (ETP) was shown, as well as a statistically significant decrease in the parameter of TGT: lag period (tlag) in pregnant women with placental insufficiency and preeclampsia compared with the comparison group (paired Student’s t-test, ANOVA, p < 0.05).

Conclusion. The parameters of the state of the hemostatic system in pregnant women with venous insufficiency and thrombophilia while taking a prophylactic dose of LMWH do not differ from each other and from the comparison group. ETP and the lag period of the group of pregnant women with placental insufficiency and preeclampsia significantly differ from the comparison group and other studied groups, showing a greater tendency to increased thrombosis.


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About the authors

Irina V. Gribkova

Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department

Author for correspondence.
Email: igribkova@yandex.ru
ORCID iD: 0000-0001-5136-1752

Russian Federation, 121096, Moscow

MD, PhD

Nataliya S. Koroleva

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: tashakoroleva@gmail.com
ORCID iD: 0000-0002-4525-9054
SPIN-code: 6735-7459

Russian Federation, 119991, Moscow

Andrey V. Murashko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: murashkoa@mail.ru
ORCID iD: 0000-0003-0663-2909
SPIN-code: 2841-9638

Russian Federation, 119991, Moscow

MD, PhD, Professor

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