Congress of the International Society on Thrombosis and Haemostasis

Monitoring of haemocoagulation changes during long-term low molecular weight heparin protection of pregnancy

Abstract number: PP-TH-368

Sigutova¹ P., Hajsmanova¹ Z., Slechtova¹ J., Ulcova-Gallova² Z.

¹¹Institute of Clinical Biochemistry and Haematology ²²Department of Obstetrics and Gynaecology, University Hospital, Plzen, Czech Republic

How-to-cite Sigutova P, Hajsmanova Z, Slechtova J, Ulcova-Gallova Z. Monitoring of haemocoagulation changes during long-term low molecular weight heparin protection of pregnancy. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-TH-368

Introduction: Recurrent fetal loss (RFL) is a common health problem affecting 1–5% of women at the reproductive age. METHODS AND RESULTS: We examined 67 pregnant women (22–40 years) with RFL in previous pregnant history treated by long-term prophylactic administration of low molecular weight heparin (LMWH). This group was compared with a cohort of healthy pregnant women LMWHs untreated. Blood samples were collected before gestation and at 10^th, 20^th, 30^th gestational weeks. The screening coagulation tests were performed to exclude the possibility of coagulation disorders. D-dimer level, F VIII activity, vWF antigen, protein C activity (PC), protein S activity (PS), type 1 plasminogen activator inhibitor activity (PAI-1), alfa2-antiplasmin (AP), plasminogen activity were measured in each sample. Tissue-type plasminogen activator (t-PA) antigen and thrombomodulin antigen were measured by immunoassay. Statistical analysis was used (P < 0.05 is significant). Analysis showed a statistically significant increase of procoagulant factors (F VIII activity and vWF), a reduction of anticoagulants (PC; PS), and a rise of D-dimer and a mild rise of thrombomodulin with gestational age. With regard to fibrinolysis, there was an increase both t-PA and PAI-1 during pregnancy. The t-PA values were always comprised in the normal range. PAI-1 has been increased with respect to control values since 31^st week. The most significant variations of the D-dimer levels were recorded up to the 10^th week; they progressively increased in untreated cohort since the 30^th week onwards. CONCLUSIONS: Pregnant women with own history of RFL treated by the long-term prophylactic dose of LMWHs during pregnancy have the same values of the coagulation parameters as the control cohort in spite of the fact that the clinical efficacy of administered LMWHs is high. 94% effectiveness of LMWHs means in fact deliveries in 60 women, and 63 liveborn babies delivered without any complication. Our results suggest that our selected coagulation parameters are too rough to record changes on cellular or subcellular level.

Supported by a grant IGA MZ CR NR8917–3.

Keywords: Recurrent Fetal Loss, Pregnancy, Haemostasis, Low Molecular Weight Heparin.

Disclosure of interest: none declared.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

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Date:	Unpresented
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Session name:	ISTH2009
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