[Studies on coagulation-fibrinolysis during normal pregnancy, labor and puerperium using recently developed molecular...

The purpose of this study is to further investigate physiologic changes in plasma coagulation-fibrinogenolysis and fibrinolysis in the utero-placental circulation in normal pregnancy, labor and puerperium, employing newly developed molecular markers for coagulation-fibrinogenolysis and fibrinolysis such as prothrombin fragment 1 + 2 (F1.2), active PAI-1, Fgfr and Fbfr. In 30 non-pregnant women and 20 normal pregnant women, the levels of plasma F1.2, TAT, FPA, Fgfr and active PAI-1 were noticeably increased from the first trimester to the full term. tPA/PAI-1/C and B beta 15-42 were also increased as gestation advanced. These findings suggested that noticeably activated states of coagulation, fibrinogenolysis and fibrinolysis exist in normal pregnancy. In 30 cases of placental circulation in healthy pregnant women and at 20-30 minutes after uteroplacental separation, the levels of plasma F1.2, TAT, FPA, tPA/PAI-1/C, PIC, B beta 15-42, Fgfr and Fbfr were noticeably increased, and the level of active PAI-1, was noticeably decreased in the uterine venous blood as compared with those of the peripheral venous blood in healthy pregnant women. At 20-30 minutes after utero-placental separation in the uterine venous blood and in peripheral venous blood, the changes in the levels of these markers were significantly increased, whereas active PAI-1 and PI were significantly depressed compared with those in healthy pregnant women. These findings suggest that further enhancement of local coagulation-fibrinolysis occurred in utero after separation of the placenta.