Analysis of blood coagulation indexes, thromboelastogram and autoantibodies in patients with recurrent pregnancy loss

Yao, Huizhen; Ji, Yimei; Zhou, Yanru

doi:10.12669/pjms.38.7.6284

Cited by 7 publications

(14 citation statements)

References 27 publications

(32 reference statements)

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“…In such a situation, a parturient woman may be at increased risk of thromboembolic disease, postpartum hemorrhage, or disseminated intravascular coagulation (DIC), posing a serious threat to both maternal and fetal health. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Clinical significance of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on hypercoagulable state of blood in parturient women

Zhang,

Yu,

Wang

et al. 2024

Pak J Med Sci

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Objective: To investigate the value of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on the evaluation of the hypercoagulable state of blood in parturient women. Methods: This is a retrospective study. Total 50 high risk parturient women who underwent an antenatal examination in Baoding Maternal and Child Health Hospital from June 2021 to January 2023 were selected as the observation group, while 50 normal parturient women who underwent antenatal examination without comorbidities and complications were randomly collected in a ratio of 1:1 as the control group. All subjects had venous blood drawn for testing of seven blood coagulation indexes, lipids and platelet agglutination before delivery, and their general data were recorded. Results: The activated partial thromboplastin time(APTT) in the observation group was lower than that in the control group, while thrombin time(TT) and D-dimer(DD) were both higher than those in the control group, with statistically significant differences(p<0.05); total cholesterol (TC) and triglyceride (TG) in the observation group were both higher than those in the control group, with statistically significant differences (p<0.05); adenosine diphosphate (ADP) and arachidonic acid (AA) in the observation group were both higher than those in the control group, with statistically significant differences (p<0.05). Moreover, the overall incidence of adverse pregnancy was higher in the observation group than in the control group, with a statistically significant difference (p<0.05). Conclusions: The combined test of seven blood coagulation indexes, lipids and platelet agglutination results in excellent performance in predicting and judging the presence or absence of the hypercoagulable state of blood in parturient women, with the combination of APTT+TT+DD+TG+ADP+AA being the preferred test. doi: https://doi.org/10.12669/pjms.40.4.7530 How to cite this: Zhang W, Yu T, Wang Y, Hu M, Gao T. Clinical significance of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on hypercoagulable state of blood in parturient women. Pak J Med Sci. 2024;40(4):741-746. doi: https://doi.org/10.12669/pjms.40.4.7530 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Clinical significance of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on hypercoagulable state of blood in parturient women

Zhang,

Yu,

Wang

et al. 2024

Pak J Med Sci

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“…The pathogenesis of RSA is complex, and the etiology of RSA is still unclear in approximately half of cases. Common factors affecting the RSA rate include genetics, endocrine disorders, chromosomal abnormalities, autoimmune abnormalities ( 2 ). Among the numerous studies exploring etiological mechanisms, a notable connection has been established between thyroid autoimmunity (TAI) and the risk of RSA ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study

Zhang,

Song,

Yuan

et al. 2024

Front. Endocrinol.

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BackgroundThe etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions.MethodsA retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies.ResultsThe prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients.ConclusionTAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.

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“…Elevated levels of d-dimer during pregnancy are thought to be associated with recurrent abortion, Venous thromboembolism, and other adverse outcomes of pregnancy. [1][2] Due to the gestational age increases, so does d-dimer level; therefore, the cut-off value of 0.5mg/L in the normal population doesn't t the pregnancy population fully.A study suggests 2.5 th -97.5 th percentiles of d-dimer were 0.01-0.31mg/L in the rst trimester and continue to increase in the mid and third trimesters. 3 A randomized controlled trial in China also revealed that women with a level of d-dimer <0.5mg/L had higher live birth rates compared with >0.5mg/L in the rst trimester.…”

Section: Introductionmentioning

confidence: 99%

Uncontrollable Elevating D-dimer During Pregnancy and Formation of Fetal Umbilical Artery Thrombosis: a Case Report

Lin

Zhan

Xiao

2023

Preprint

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Background: Elevated levels of d-dimer during pregnancy are thought to be associated with adverse outcomes of pregnancy. Some obstetrician suspect maternal hypercoagulability may lead placenta or umbilical vascular thrombosis, which could cause fetal death in third trimester. However those hypothesis is lack of evidence of evidence-based medicine.Our case is unique because we regular screening level of d-dimer since first trimester. And we had ran scrutinize detailed inspection in other possible causes of umbilical artery thrombosis, including fetal chromosome abnormalities, umbilical cord abnormalities, immunological abnormalities, which all show negative results. This leads us to the conclusion that maternal hypercoagulability can directly lead to the formation of umbilical artery thrombosis. Case presentation: A 29-year-old patient, a primigravida, was revealed the elevating d-dimer levels of 0.51mg/L in early pregnancy(normal level <0.5mg/L). With the clinical experience, the attending doctor considered the elevation of d-dimer levels were prompting a high risk of venous thromboembolism and spontaneous abortion potential and opted to treat the patient with low molecular weight heparin. After treatment,the level of d-dimer still sharply raising.Obstetrician choose to stop treatment in 36 gestational weeks.After tow weeks fetal death occurs. Postpartum pathological analysis confirmed formation of fetal umbilical artery thrombosis. Conclusions: Maternal hypercoagulable state could cause umbilical vascular thrombosis.As a reliable indicator of coagulation function, it’s maybe necessary for regular screening the level of d-dimer for pregnant women in different trimester.The cut off values of d-dimer in different gestational weeks should be determined according to different race and inspection methods. Low molecular weight heparin maybe effective treatment for pregnant women with abnormal elevation of d-dimer.

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Analysis of blood coagulation indexes, thromboelastogram and autoantibodies in patients with recurrent pregnancy loss

Cited by 7 publications

References 27 publications

Clinical significance of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on hypercoagulable state of blood in parturient women

Clinical significance of the combined test of seven blood coagulation indexes, lipids and platelet agglutination on hypercoagulable state of blood in parturient women

The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study

Uncontrollable Elevating D-dimer During Pregnancy and Formation of Fetal Umbilical Artery Thrombosis: a Case Report

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