Hepatodepressive syndrome caused by pregnancy

Abstract

Insolvency of hepatocyte’s reserve possibilities, characterized by decrease of its synthetic function followed by qualitative and quantitative inner link of hemostasis defects, is one of the variants of organisms disadaptation for pregnancy and it is called “hepatodepressive syndrome” (HDS). This research was aimed to the investigation of dynamics of hemostasiological and bioëchemical parameters of blood, peculiarities of pregnancy, labour and perinatal outcome, developed in women with diagnosed laboratory markers of HDS beginning from the first or the second trimester of pregnancy.

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Subjects and methods: We examined 32 patients with HDS and 24 women with normal pregnancy development. Clinical, hemostasiological (Tr, Fg, TT, KT, APTV, PTI), biochemical parameters were measured. The results were processed with the use of Student criteria.

Results: Physiological increase of coagulating blood potential with the progression of pregnancy was not registered in women with HDS; decrease of thrombocytes number (p<0,01); prolongation of APTT (p<0,001); decrease of PTI (p<0,01) was registered to the III trimester. Reliable decrease of FG level (p<0,01), rise of 62-macroglobulin activity (p<0,001), increase of transferrin concentration (p<0,001), rise of transaminase activity (p<0,05) were proved. Clinical evaluation of pregnant women with preclinically diagnosed HDS revealed that pregnancy and labour were complicated: preeclampsia developed in 93,7%) of cases; fetoplacental insufficiency was diagnosed in 71,8% and intrauterine growth retardation — in 37,5% of cases.

Discussion: according to our data preclinical evaluation of biochemical and hemostasiological parameters is necessary for early diagnosis and following pathogenetic treatment of HDS in pregnancy.