Archives of Gynecology and Obstetrics

, Volume 285, Issue 5, pp 1231–1236

Changes in coagulation and hemodynamics during pregnancy: a prospective longitudinal study of 58 cases

  • Chen Hui
  • Meng Lili
  • Chen Libin
  • Zhang Rui
  • Guo Fang
  • Gao Ling
  • Zhang Jianping
Maternal-Fetal Medicine

DOI: 10.1007/s00404-011-2137-x

Cite this article as:
Hui, C., Lili, M., Libin, C. et al. Arch Gynecol Obstet (2012) 285: 1231. doi:10.1007/s00404-011-2137-x

Abstract

Purpose

To investigate changes and establish reference values in coagulation, anticoagulation, fibrinolysis, anti-fibrinolysis and hemodynamics during normal pregnancy.

Methods

A total of 58 women with singleton pregnancies were recruited. Blood and ultrasound examinations were performed in the 10th–14th, 20th–24th, and 30th–34th weeks of pregnancy. The same examinations were performed in 50 non-pregnant women who were selected as the control group.

Results

Levels of fibrinogen, thrombin time, fibronectin, prothrombin activated fragments 1+2 and thrombomodulin were higher in early pregnancy than those in the control group (P < 0.05). Fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time, thromboxane B2, prothrombin activated fragments 1+2, thrombomodulin, D-dimer, and plasminogen activator inhibitor-2 were statistically different between the mid pregnancy and the control group (P < 0.05). Meanwhile, fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time, fibronectin, thromboxane B2, prothrombin activated fragments 1+2, thrombomodulin, and plasminogen activator inhibitor-2 were obviously elevated in late pregnancy as compared with the control group (P < 0.05). Moreover, fibrinogen, thromboxane B2, prothrombin activated fragment 1+2, D-dimer plasminogen, and activator inhibitor-2 gradually increased during pregnancy with some fluctuation. Prothrombin time, activated partial thromboplastin time, thrombin time, international normalized ratio, and thrombomodulin as well as systolic/diastolic ratio, pulsatility index, and resistance index in uterine arteries showed a tendency to decrease in pregnant women.

Conclusions

Coagulation, anti-coagulation, fibrinolytic and anti-fibrinolytic activities are enhanced and balanced at a higher level during pregnancy. In addition, uterine artery and umbilical artery hemodynamics become more baby friendly (i.e., high flow and low resistance).

Keywords

Hemodynamics Hemostasis Pregnancy Ultrasound 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Chen Hui
    • 1
  • Meng Lili
    • 1
  • Chen Libin
    • 1
  • Zhang Rui
    • 1
  • Guo Fang
    • 2
  • Gao Ling
    • 3
    • 4
  • Zhang Jianping
    • 1
  1. 1.Department of Obstetrics and GynecologySun Yat-sen Memorial Hospital of Sun Yat-sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of Gynecology and ObstetricsGuangzhou Women and Children’s Medical CenterGuangzhouPeople’s Republic of China
  3. 3.Department of Clinical LaboratoryThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China
  4. 4.Department of Laboratory MedicineThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China

Personalised recommendations