title: Thrombosis Prediction Based on Reference Ranges of Coagulation-Related Markers in Different Stages of Pregnancy.
abstract: BACKGROUND
  Careful monitoring of the hypercoagulable state is required during pregnancy. However, coagulation and fibrinolysis markers are not fully utilized because there are no reference values reflective of coagulation and fibrinolysis dynamics during pregnancy, which differ from the nonpregnant state.
  
  
  METHODS
  Changes in antithrombin (AT), fibrinogen (Fbg), prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), soluble fibrin (SF), D-dimer (DD), and protein S (PS) were investigated in healthy pregnant women, and reference ranges in the early, mid, late, and end stages of pregnancy were established.
  
  
  RESULTS
  The AT was essentially constant throughout pregnancy. The Fbg, F1+2, TAT, and DD increased significantly as pregnancy progressed. In contrast, SF did not show a significant increase throughout the entire pregnancy period. Total PS antigen and total PS activity showed a corresponding decrease from early gestation. When test data in 3 cases in which deep vein thrombosis or intrauterine fetal death occurred during pregnancy were compared to the established reference ranges, all of the cases had multiple markers with values that exceeded the reference ranges.
  
  
  CONCLUSIONS
  Establishing reference ranges for each week could potentially make it possible to evaluate abnormalities of the coagulation and fibrinolysis systems during pregnancy. Of note, SF might be a useful marker that reflects thrombus formation during pregnancy. Larger-scale studies will be required to establish reference ranges for every gestational week.
authors.affiliation: 1 Department of Clinical Laboratory Science, Kanazawa University Graduate School, Kodatsuno, Kanazawa, Ishikawa, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sekiya
authors.affiliation: 2 Department of Hematology, Kanazawa City Hospital, Heiwa-machi, Kanazawa, Ishikawa, Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: 3 Department of Internal Medicine (III), Kanazawa University, Takara-machi, Kanazawa, Ishikawa, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kadohira
authors.affiliation: 4 Department of Clinical Laboratory, Kanazawa University Hospital, Takara-machi, Kanazawa, Ishikawa, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Shibayama
authors.affiliation: 5 Shino-Test Corporation, Oonodai, Minami-ku, Sagamihara, Kanagawa, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: 5 Shino-Test Corporation, Oonodai, Minami-ku, Sagamihara, Kanagawa, Japan.
authors.forename: Xiuri
authors.initials: X
authors.lastname: Jin
authors.affiliation: 1 Department of Clinical Laboratory Science, Kanazawa University Graduate School, Kodatsuno, Kanazawa, Ishikawa, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Nomoto
authors.affiliation: 3 Department of Internal Medicine (III), Kanazawa University, Takara-machi, Kanazawa, Ishikawa, Japan.
authors.forename: Hidesaku
authors.initials: H
authors.lastname: Asakura
authors.affiliation: 4 Department of Clinical Laboratory, Kanazawa University Hospital, Takara-machi, Kanazawa, Ishikawa, Japan.|6 Division of Nephrology, Department of Laboratory Medicine, Kanazawa University, Takara-machi, Kanazawa, Ishikawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Wada
authors.affiliation: 1 Department of Clinical Laboratory Science, Kanazawa University Graduate School, Kodatsuno, Kanazawa, Ishikawa, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ohtake
authors.affiliation: 1 Department of Clinical Laboratory Science, Kanazawa University Graduate School, Kodatsuno, Kanazawa, Ishikawa, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Morishita
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001777:Blood Coagulation; D005260:Female; D005337:Fibrin / Q000032:analysis; D005865:Gestational Age; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D012016:Reference Values; D013927:Thrombosis / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005337:Fibrin
keywords: coagulation markers; pregnancy; reference range; soluble fibrin