Haemostatic reference intervals in pregnancy
| Autor: | Pal B. Szecsi, Anna Klajnbard, Steen Stender, Malene R. Andersen, Maja Jørgensen, Nina P. Colov |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty Gestational Age Fibrinogen Antithrombins Protein S Cohort Studies Fibrin Fibrinogen Degradation Products Predictive Value of Tests Pregnancy Reference Values Internal medicine D-dimer medicine Humans Prothrombin time Hemostasis medicine.diagnostic_test biology business.industry Obstetrics Postpartum Period Pregnancy Complications Hematologic Antithrombin Hematology medicine.disease Blood Coagulation Factors Endocrinology Prothrombin Time biology.protein Female Partial Thromboplastin Time Blood Coagulation Tests business Biomarkers Postpartum period Protein C medicine.drug Partial thromboplastin time |
| Zdroj: | Thrombosis and Haemostasis. 103:718-727 |
| ISSN: | 2567-689X 0340-6245 |
| DOI: | 10.1160/th09-10-0704 |
| Popis: | SummaryHaemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13–20, 21–28, 29–34, 35–42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S, and protein C and in a subgroup of 186 women in addition for prothrombin time (PT), Owren and Quick PT, protein S activity, and total protein S and coagulation factors II, V, VII, VIII, IX, X, XI, and XII. The level of coagulation factors II, V, X, XI, XII and antithrombin, protein C, aPTT, PT remained largely unchanged during pregnancy, delivery, and postpartum and were within non-pregnant reference intervals. However, levels of fibrinogen, D-dimer, and coagulation factors VII, VIII, and IX increased markedly. Protein S activity decreased substantially, while free protein S decreased slightly and total protein S was stable. Gestational age-specific reference values are essential for the accurate interpretation of a subset of haemostatic tests during pregnancy, delivery, and puerperium. |
| Databáze: | OpenAIRE |
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