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Changes in hemostasis activity during delivery and the immediate postpartum period
F R Gerbasi1, S Bottoms, A Farag
1Department of Anesthesiology, Wayne State University, Hutzel Hospital, Detroit, MI 48201.
American Journal of Obstetrics and Gynecology
|May 1, 1990
Summary
Delivery significantly increases markers of platelet activation and fibrin formation, alongside fibrinolysis, in postpartum women. These hemostatic changes may increase the risk of deep vein thrombosis.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Thrombosis Research
Background:
- Postpartum deep vein thrombosis (DVT) is linked to hemostasis system activation during delivery.
- Previous studies had small sample sizes or used in vitro hemostasis tests.
Purpose of the Study:
- To investigate the in vivo effect of delivery on hemostasis in healthy pregnant women.
- To measure multiple hemostatic indices simultaneously using advanced technology.
Main Methods:
- Simultaneously measured 11 hemostatic indices in 70 healthy pregnant women.
- Assessed hemostasis at the time of delivery and 3 hours postpartum.
Main Results:
- Significant increases in fibrinopeptide A, beta-thromboglobulin, and platelet factor 4 indicated peak platelet activation and fibrin formation at delivery.
- Elevated D-dimer and fibrin-fibrinogen degradation products, with decreased alpha 2-antiplasmin, suggested maximum fibrinolysis postpartum.
- These findings demonstrate a peak in hemostatic activity during delivery and the immediate postpartum period.
Conclusions:
- Delivery induces significant in vivo hemostatic activation, including platelet activation, fibrin formation, and fibrinolysis.
- The observed hemostatic changes may contribute to the predisposition for postpartum deep vein thrombosis.