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Haemostasis in normal pregnancy.

Y Stirling, L Woolf, W R North

    Thrombosis and Haemostasis
    |October 31, 1984
    PubMed
    Summary
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    Pregnancy significantly alters blood clotting factors, with many increasing and fibrinolysis decreasing, suggesting mild intravascular coagulation may occur. These changes in haemostatic variables are crucial for understanding pregnancy-related blood dynamics.

    Area of Science:

    • Obstetrics and Gynecology
    • Hematology
    • Physiology

    Background:

    • Pregnancy involves complex physiological adaptations, including significant alterations in the haemostatic system.
    • Understanding these changes is vital for managing potential complications such as thrombosis and hemorrhage.

    Purpose of the Study:

    • To systematically document changes in multiple haemostatic variables during and after pregnancy in 72 women.
    • To investigate the dynamic alterations in coagulation factors, inhibitors, and fibrinolytic activity throughout gestation.

    Main Methods:

    • Prospective study involving 72 women.
    • Measurement of a wide range of haemostatic variables, including coagulation factors (II, V, VII, X, fibrinogen), inhibitors (antithrombin III, alpha 1-antitrypsin, alpha 2 macroglobulin), and fibrinolytic markers (fibrin degradation products).

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  • Analysis of changes across different stages of pregnancy and postpartum.

    • Main Results:

    • Marked increases observed in Factors VII, VIII:C, VIIIR:Ag, X, fibrinogen, and alpha 1-antitrypsin throughout pregnancy.
    • Factors II and V, and alpha 2 macroglobulin initially increased but then declined; Antithrombin III levels slightly decreased.
    • Significant reduction in fibrinolytic activity from 11-15 weeks, with rising fibrin degradation products from 21-25 weeks.

    Conclusions:

    • The observed rise in coagulation factors may result from increased synthesis or thrombin activation.
    • Findings suggest a potential mild, localized intravascular coagulation in some women during pregnancy.
    • These haemostatic shifts highlight the prothrombotic state often associated with normal pregnancy.