Nonclinical aspects of venous thrombosis in pregnancy

Abstract

Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non-animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug-induced venous thrombosis.

Combined thrombogenic effects of vessel injury, pregnancy and procoagulant immune globulin administration in mice

“…Association of pregnancy with thrombosis following IG therapy has not been reported to date and studies in gravid animals have not been performed. Although most in vivo animal research, including coagulation and hemostasis studies, are performed in mice, there is little to no information about whether pregnant mice (or any other species) recapitulate the hypercoagulable state of human pregnancy [ 24 ]. Compared with in vitro studies, an in vivo model should capture the dynamics and three-dimensional extent of clot formation in the setting of physical effects of blood flow, and dynamic replenishment of pro- and anti-coagulant factors.…”

Информативность Скринингового Обследования Параметров Коагуляции Для Прогнозирования Раннего Выкидыша: Обзор Литературы

“…Поэтому рутинные тесты на свертываемость крови чрезвычайно важны беременным для контроля свертывающей и фибринолитической систем [22]. ПТИ, ПВ, АЧТВ, фибриноген, показатель тромбоцитов стали одними из основных скрининговых тестов параметров коагуляции в Казахстане и других странах, таких как Китай [22][23][24], Япония [2], РФ [25], США [26,27]. За последние 10 лет опубликован ряд работ, которые рассматривают вопросы нецелесообразности применения системы исчисления лабораторных показателей беременных и небеременных женщин.…”

Hematologic Findings in Pregnancy: A Guide for the Internist

“…Pregnancy produces a physiological hypercoagulable state that is caused by changes in the coagulation system [ 68 ]. As pregnancy progresses, the risk of hypercoagulability increases because of decreasing levels of protein S and increasing levels of thrombogenic factors VII, VIII, and X; vWF; and fibrinogen [ 69 ]. The risk of coagulation complications, such as venous thromboembolism, is highest in the immediate postpartum period, and the risk slowly decreases back to pre-pregnancy levels by eight to 12 weeks post-partum [ 70 ].…”