title: Changes in coagulation and hemodynamics during pregnancy: a prospective longitudinal study of 58 cases.
abstract: OBJECTIVE
  To investigate changes and establish reference values in coagulation, anticoagulation, fibrinolysis, anti-fibrinolysis and hemodynamics during normal pregnancy.
  
  
  METHODS
  A total of 58 women with singleton pregnancies were recruited. Blood and ultrasound examinations were performed in the 10th-14th, 20th-24th, and 30th-34th weeks of pregnancy. The same examinations were performed in 50 non-pregnant women who were selected as the control group.
  
  
  RESULTS
  Levels of fibrinogen, thrombin time, fibronectin, prothrombin activated fragments 1+2 and thrombomodulin were higher in early pregnancy than those in the control group (P < 0.05). Fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time, thromboxane B2, prothrombin activated fragments 1+2, thrombomodulin, D-dimer, and plasminogen activator inhibitor-2 were statistically different between the mid pregnancy and the control group (P < 0.05). Meanwhile, fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time, fibronectin, thromboxane B2, prothrombin activated fragments 1+2, thrombomodulin, and plasminogen activator inhibitor-2 were obviously elevated in late pregnancy as compared with the control group (P < 0.05). Moreover, fibrinogen, thromboxane B2, prothrombin activated fragment 1+2, D-dimer plasminogen, and activator inhibitor-2 gradually increased during pregnancy with some fluctuation. Prothrombin time, activated partial thromboplastin time, thrombin time, international normalized ratio, and thrombomodulin as well as systolic/diastolic ratio, pulsatility index, and resistance index in uterine arteries showed a tendency to decrease in pregnant women.
  
  
  CONCLUSIONS
  Coagulation, anti-coagulation, fibrinolytic and anti-fibrinolytic activities are enhanced and balanced at a higher level during pregnancy. In addition, uterine artery and umbilical artery hemodynamics become more baby friendly (i.e., high flow and low resistance).
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Yanjiang Road 107, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Hui
authors.forename: Meng
authors.initials: M
authors.lastname: Lili
authors.forename: Chen
authors.initials: C
authors.lastname: Libin
authors.forename: Zhang
authors.initials: Z
authors.lastname: Rui
authors.forename: Guo
authors.initials: G
authors.lastname: Fang
authors.forename: Gao
authors.initials: G
authors.lastname: Ling
authors.forename: Zhang
authors.initials: Z
authors.lastname: Jianping
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism*; D005353:Fibronectins / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D008137:Longitudinal Studies; D010446:Peptide Fragments / Q000378:metabolism; D017396:Plasminogen Activator Inhibitor 2 / Q000378:metabolism; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D011516:Prothrombin / Q000378:metabolism; D018180:Thrombomodulin / Q000378:metabolism; D013929:Thromboxane B2 / Q000378:metabolism; D055815:Young Adult
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D005353:Fibronectins; D010446:Peptide Fragments; D017396:Plasminogen Activator Inhibitor 2; D018180:Thrombomodulin; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D013929:Thromboxane B2; D011516:Prothrombin; D005340:Fibrinogen