title: [Clinical management of disorders hemostasis-related with obstetric complications].
abstract: BACKGROUND
  The aim of the study was the reduction of adverse pregnancy outcomes in women with gestational and genetically determined changes in the hemostatic system.
  
  
  METHODS
  The study group comprised 98 patients with obstetric complications on the background of changes in the parameters of coagulation screening. In 63 pregnant women, hemostatic disorders were not corrected, in 35 patients medical tactic defined clinical situation and the results of laboratory and instrumental studies of the hemostatic system.
  
  
  RESULTS
  Hereditary thrombophilia detected in 85% of patients with obstetric complications. Carriage of the rare allele of MTHFR-677 2-fold increased risk of adverse pregnancy outcomes; heterozygous carriers of polymorphism PAI-1 - 1.5 times more. The prognostic parameters thrombelastographic (sensitivity 80%, specificity 82%) were higher than in laboratory tests. To determine the most predictive of adverse pregnancy outcome has a density of fibrin clot--the maximum amplitude.
  
  
  CONCLUSIONS
  In women with obstetric complications associated with disturbances in the hemostatic system, medical diagnostic tactics using c thrombelastographic evaluates all stages of coagulation and fibrinolysis, allows you to select a reasonable pathogenetic anticoagulant therapy and reduce the number of adverse pregnancy outcomes.
authors.forename: S V
authors.initials: SV
authors.lastname: Barinov
authors.forename: V T
authors.initials: VT
authors.lastname: Dolgikh
authors.forename: I V
authors.initials: IV
authors.lastname: Mediannikova
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D005260:Female; D006487:Hemostasis / Q000235:genetics; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011256:Pregnancy Outcome; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013916:Thrombelastography / Q000295:instrumentation / Q000379:methods; D019851:Thrombophilia / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D000925:Anticoagulants; D017395:Plasminogen Activator Inhibitor 1; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)