title: Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia.
abstract: BACKGROUND
  Preeclampsia (PE) is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE.
  
  
  OBJECTIVE
  We aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE.
  
  
  METHODS
  Blood samples from 3 groups of subjects, normal pregnant women (n = 79), mild preeclampsia (mPE) (n = 53) and severe preeclampsia (sPE) (n = 42), were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC) curves of these indices were generated, and the area under the curve (AUC) was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis.
  
  
  RESULTS
  During late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV) increased compared to early pregnancy (p<0.05). However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD) during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743) and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671) and ideal predictive efficiency.
  
  
  CONCLUSIONS
  Normal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE, respectively.
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China; Department of Obstetrics and Gynecology, the 306th Hospital of the Chinese People's Liberation Army, Beijing, P.R.China.
authors.forename: Lei
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of General Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Jiaqun
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Zhiling
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Jian
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Lili
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Yingru
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D001792:Blood Platelets / Q000473:pathology*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000473:pathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D055815:Young Adult