title: Coagulation/fibrinolysis and laboratory characteristics of pregnant women with severely depressed antithrombin activity.
abstract: OBJECTIVE
  To examine the pathophysiology of reductions in antithrombin (AT) activity during pregnancy and to better characterize the laboratory features of pregnant women with severely depressed AT activity.
  
  
  METHODS
  Laboratory variables for blood samples obtained within 5 d prior to delivery were compared among three women groups with severely depressed (<45%, n = 6), modestly depressed (45-69%, n = 10), and normal AT activity levels (>70%, n = 134).
  
  
  RESULTS
  Pregnancy-induced hypertension was present in 16.7% (1/6), 30.0% (3/10), and 9.0% (12/134) of the women with the above-mentioned AT activities, respectively. The AT activities were significantly and negatively correlated with the D-dimer, urate, and creatinine levels. The D-dimer level was significantly and negatively correlated with the fibrinogen level. Women with AT activity <45% exhibited markedly elevated levels of hemoglobin and liver enzymes and a significantly lower level of fibrinogen than the other women groups, while the platelet count did not differ among the three groups.
  
  
  CONCLUSIONS
  Enhanced thrombin generation was involved in the decrease in AT activity. AT activity can decrease in the absence of thrombocytopenia. The liver dysfunction that was seen in cases with severely depressed AT activity may have resulted from impairments in liver perfusion caused by microthromboses generated as a result of the relative lack of AT and/or the shortage of circulating plasma in women with reduced AT activities.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. yamataka@med. hokudai.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Soromon
authors.initials: S
authors.lastname: Kataoka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Uda
authors.forename: Youichiro
authors.initials: Y
authors.lastname: Iinuma
authors.forename: Rifumi
authors.initials: R
authors.lastname: Hattori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000991:Antithrombins / Q000097:blood*; D001778:Blood Coagulation Disorders / Q000097:blood* / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood; D008099:Liver / Q000503:physiopathology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000503:physiopathology; D012189:Retrospective Studies; D014527:Uric Acid / Q000097:blood
chemical_list: D000991:Antithrombins; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014527:Uric Acid; D005340:Fibrinogen; D003404:Creatinine