Hemostatic changes in pregnancy

Simioni, Paolo; Campello, Elena

doi:10.7175/rhc.v4i3s.878

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…In this study, significantly lower and fluctuations of platelet counts have been observed during pregnancy compared to the puerperium. These findings are in agreement with earlier reports [5,[11][12][13]. Thrombocytopaenia has been associated with haemodilution and accelerated platelet consumption during pregnancy [13][14][15] while increased platelet count during puerperium could be associated with consumption of platelets and blood coagulation factors during delivery [6].…”

Section: Discussionsupporting

confidence: 93%

Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Momodu¹,

Ajayi²

2015

J Hematol Thrombo Dis

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Aim: Normal pregnancy is associated with haemostatic changes which have been linked to a complex physiological adaptation but these changes return to that of non-pregnant state at about 4 weeks of post-delivery. This study was undertaken to monitor the haemostatic changes during pregnancy and puerperium in NorthWestern Nigeria. Materials and methods: Ten pregnant women, aged 17-40 years were monitored for haemostatic changes from the first trimester to 6 weeks after delivery between August 2010 and October 2011 at Aminu Kano Teaching Hospital, Kano. Blood samples collected for platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation products (FDP), fibrinogen level, d-dimer, protein C, factors VII and VIII activities were analysed using standard laboratory techniques. Results: There were significantly lower values of platelet count, factor VIII concentration and protein C activity of 275.5 ± 4.14 × 10 9 /L, 93.2 ± 31.6% and 56.7 ± 13.4% during pregnancy compared to 378.5 ± 74.0 × 10 9 /L, 122.5 ± 3.0% and 97.1 ± 14.6% respectively, during puerperium. The values of PT, factor VII concentration, fibrinogen level, FDP and D-dimer concentrations during pregnancy and puerperium showed no significant differences (P>0.05). Factors VII and VIII concentrations increased significantly as gestation advanced (P<0.05). Conclusion: The study concluded that changed values of platelet count, protein C and factor VIII concentrations during pregnancy, normalized at puerperal period while advanced gestation may pose a threat to pregnancy. It is recommended that protein C, factors VII and VIII concentrations be monitored during pregnancy to minimize thrombotic effect.

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Section: Discussionsupporting

confidence: 93%

Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Momodu¹,

Ajayi²

2015

J Hematol Thrombo Dis

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“…There was significant difference in the levels of APTT when compared among the trimesters. This also agrees with the study of [17,18] who followed the same pattern. This might be due to increased synthesis or increased activation by coagulation factors.…”

Section: It Is Also Consistent With the Work Done By Hellgren In 2003supporting

confidence: 92%

Prothrombin Time and Activated Partial Thromboplastin Time in Pregnant Women Attending Antenatal Clinic at Nnamdi Azikiwe University Teaching Hospital (Nauth), Nnewi, Nigeria – A Cohort Study

Oluchi¹,

Augustine²,

Johnkennedy³

et al. 2020

Clinic Res Urol

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The hemostatic balance tilts in the direction of hypercoagulability which helps to reduce bleeding complications during delivery. [1] The changes in the coagulation system during normal pregnancy are consistent with a continuing low-grade process of intravascular coagulation. [2] The hormones which are necessary for the maintenance of pregnancy, that is, estrogen and progesterone increase several folds and these, especially estrogen stimulate hepatocytes thereby increasing the production of virtually all coagulation factors. Evaluation of levels of certain coagulation factors occur in practically all healthy pregnant women which are most likely the result of small amounts

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“…Both plasma volume (+40%) and red blood cell volume (+25%) increase, leading to a state of haemodilution; as a result, approximately one‐third of pregnant women are anaemic at term 11 . Due to dilution and consumption by the uteroplacental unit, platelet count decreases during pregnancy from the first trimester, with the greatest reduction occurring during the third trimester 8 ; however, it increases immediately after delivery, especially in cases of caesarean delivery 11 …”

Section: Coagulation Profile Of Women With Pphmentioning

confidence: 99%

“…There are many haemostatic changes in normal pregnancy, including an increase in procoagulant factors (V, VII, VIII, IX, X, XII and von Willebrand factors), a decrease in some of natural anticoagulants (reduced protein S activity and acquired activated protein C resistance) and a decrease in fibrinolytic activity. These changes occur to support placental function but may lead to a state of hypercoagulability, resulting in an increased risk of thrombosis and placental vascular complications 11 …”

Section: Coagulation Profile Of Women With Pphmentioning

confidence: 99%

Practical approach to transfusion management of post‐partum haemorrhage

Frigo

Agostini

Brizzi

et al. 2021

Transfusion Medicine

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Objectives To describe transfusion management during post‐partum haemorrhage (PPH) and the usefulness of standard or point‐of‐care (POC) laboratory tests for guiding haemostatic management. Background PPH is the leading cause of maternal mortality and severe maternal morbidity worldwide. Despite the efforts made in recent years, PPH is often burdened by preventable death. Recent data from the active Italian Obstetric Surveillance System (ItOSS) highlighted the following main critical issues: inadequate communication between healthcare professionals, inability to correctly and promptly assess the severity of haemorrhage, delays in diagnosis and treatment, failure to request blood promptly and inappropriate monitoring post‐partum. Materials and Methods Data in the literature have been compared with the rotational thromboelastometry (ROTEM)‐ and the thromboelastography (TEG)‐guided algorithms applied in the authors' departments. Results PPH transfusion therapy may have an empirical approach based on the standard use of blood products or a targeted approach based on coagulation monitoring by laboratory or POC tests. Here, the authors describe how they manage PPH in their departments, according to the Italian guidelines, along with the addition of a ROTEM‐ and a TEG‐guided algorithms developed by themselves. Conclusion Although the proposed algorithms have not been validated by trials or observational studies conducted in our departments, we believe that these indications could be useful for supporting clinical practice. Furthermore, we deem it appropriate to emphasise the importance of a multidisciplinary approach and the need for standardised and shared protocols to support the decisions of healthcare professionals.

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Hemostatic changes in pregnancy

Cited by 8 publications

References 11 publications

Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Prothrombin Time and Activated Partial Thromboplastin Time in Pregnant Women Attending Antenatal Clinic at Nnamdi Azikiwe University Teaching Hospital (Nauth), Nnewi, Nigeria – A Cohort Study

Practical approach to transfusion management of post‐partum haemorrhage

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