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Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States

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Published on: April 1, 2015

The CPLAN study: Clotting Parameters after medicaL AbortioN.

John J Reynolds-Wright^1,2, Alastair F Nimmo³, Julia A M Anderson⁴

¹Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom.

The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception

|May 20, 2025

Summary

Coagulation changes during early pregnancy and after medical abortion are minimal. This suggests shorter thromboprophylaxis durations may be sufficient for women at risk of venous thromboembolism (VTE).

Keywords:

Coagulation early pregnancy termination of pregnancy thromboelastometry thrombosis venous thromboembolism

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Area of Science:

Obstetrics and Gynecology
Hematology
Thrombosis Research

Background:

Limited data exists on coagulation changes throughout pregnancy, puerperium, and post-abortion.
Current guidance for post-abortion thromboprophylaxis is based on expert opinion and extrapolated from post-birth recommendations, with durations varying widely.
Understanding these coagulation dynamics is crucial for assessing venous thromboembolism (VTE) risk.

Purpose of the Study:

To investigate coagulation parameters in early pregnancy and following medical abortion.
To compare coagulation markers between pregnant women undergoing medical abortion and non-pregnant controls.
To inform VTE risk assessment and thromboprophylaxis guidelines post-abortion.

Main Methods:

A prospective study was conducted in a UK community abortion clinic.
Healthy pregnant women (<12 weeks gestation) and non-pregnant controls were recruited.
Coagulation markers (Clauss-fibrinogen, PT, aPTT, platelets) and viscoelastic measures were assessed pre- and post-abortion using the ClotPro® system.

Main Results:

Forty-five women (24 pregnant, 21 non-pregnant) were included.
Clauss-fibrinogen was slightly elevated pre-abortion compared to controls but remained within normal limits.
Minor pro-coagulant changes were observed in viscoelastic measures, with small absolute differences within normal ranges.

Conclusions:

First-trimester pregnancy and medical abortion are associated with minimal changes in coagulation parameters.
These coagulation changes largely resolve within 10-14 days post-abortion.
Shorter thromboprophylaxis durations may be adequate post-abortion compared to post-birth for individuals at high VTE risk.