title: Coagulation and fibrinolysis in viable mid-trimester pregnancies of normal, intrauterine growth retardation, chromosomal anomalies and hydrops fetalis and their eventual obstetric outcome.
abstract: A total of 71 pregnant women diagnosed by ultrasound to have viable fetus in late mid- trimester pregnancies of normal, IUGR, hydrops fetalis and chromosomal anomalies were studied for their coagulation, fibrinolytic and inhibitor levels with association on eventual obstetrics outcome. A hypercoagulable state was observed in all the pregnancies studied. However, higher hypercoagulation evidenced by significantly raised prothrombin formation and clot elasticity together with higher levels of D-dimer, uPA antigen and PAI-1 than observed in normal pregnancy suggests a hyperfibrinolytic/inhibitor state in hydrops fetalis pregnancy associated with bad obstetric outcome. In IUGR pregnancy associated with good outcome further enhanced clot elasticity was seen whilst no significant differences were observed in pregnancy with chromosomal anomalies when compared to uncomplicated normal pregnancy. Our study suggests that in hydrops fetalis pregnancy, further enhanced prothrombin formation and hyperfibrinolysis/inhibitor at late mid-trimester is associated with a poor obstetric outcome.
authors.affiliation: National University of Singapore, Department of Obstetrics and Gynecology, National University Hospital, Singapore.
authors.forename: S C
authors.initials: SC
authors.lastname: Koh
authors.forename: C
authors.initials: C
authors.lastname: Anandakumar
authors.forename: A
authors.initials: A
authors.lastname: Biswas
mesh_terms: D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation; D002869:Chromosome Aberrations; D005167:Factor VII / Q000032:analysis; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000097:blood*; D010446:Peptide Fragments / Q000032:analysis; D010958:Plasminogen / Q000032:analysis; D015849:Plasminogen Inactivators / Q000097:blood; D011247:Pregnancy; D011256:Pregnancy Outcome; D011516:Prothrombin / Q000032:analysis; D013916:Thrombelastography; D010959:Tissue Plasminogen Activator / Q000032:analysis; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D015849:Plasminogen Inactivators; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D000990:Antithrombin III; D005167:Factor VII; D011516:Prothrombin; D010958:Plasminogen; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator