title: Comparison of markers of coagulation activation and thrombin generation test in uncomplicated pregnancies.
abstract: BACKGROUND
  Pregnancy is a well-established risk factor for venous thromboembolism, and is associated with a state of hypercoagulability or parameters of thrombin generation. Currently, there is a lack of consensual data on thrombin generation during pregnancy. This study aimed to find a sensitive and specific biological marker of coagulation activation and to identify parameters of thrombin generation.
  
  
  METHODS
  The population included 101 women with uncomplicated pregnancies. The objective of this study was to correlate thrombin generation test (measured at 5pM tissue factor, 4μM lipids and without thrombomodulin), with fibrinogen and markers of blood coagulation activation: D-dimer, prothrombin fragments 1+2 (F1+2), thrombin-antithrombin complexes (TAT) and fibrin monomer complexes (FMC) in these women. Internal quality control was performed in each set of experiments.
  
  
  RESULTS
  Fibrinogen, D-dimer, F1+2, and TAT concentrations increased significantly throughout pregnancy, and were correlated with term of pregnancy. In our study, thrombin generation seemed to increase early on, and then remained stable throughout normal pregnancy, in contrast with other markers of blood coagulation activation, excepting FMC. The latter are subject to large inter-individual variations, especially during second trimester. No correlation was demonstrated between thrombin generation parameters and other activation markers.
  
  
  CONCLUSIONS
  While markers of coagulation activation significantly increased during pregnancy, thrombin generation increased only early on and remains stable during pregnancy. Finding a sensitive and specific biological marker for vascular pregnancy complications, such as FMC and thrombin generation levels, requires further investigation.
authors: Unit of Haemostasis, Rouen University Hospital, Rouen, France.
authors: Berangere
authors: B
authors: Joly
authors: Virginie
authors: V
authors: Barbay
authors: Jeanne-Yvonne
authors: JY
authors: Borg
authors: Veronique
authors: V
authors: Le Cam-Duchez
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000379:methods; D002138:Calibration; D005260:Female; D006487:Hemostasis; D006801:Humans; D011247:Pregnancy; D013917:Thrombin / Q000096:biosynthesis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013917:Thrombin
keywords: APC; Acquired activated protein C; CAT; Calibrated automated thrombography; ETP; Endogenous thrombin potential; F1+2; FMC; Fibrin monomer complexes; IQC; Internal quality control; NS; Non significant; PPP; Platelet-poor plasma; Prothrombin fragments 1+2; SD; Standard deviation; TAT; TF; TG; TGT; TM; Thrombin generation; Thrombin generation test; Thrombin-antithrombin complexes; Thrombomodulin; Tissue factor; Tissue plasminogen activator; Uncomplicated pregnancies; VTE; Venous thromboembolism; calibrated automated thrombogram; markers of blood coagulation activation; t-PA; thrombin generation test