25
PECULIARITIES OF HEMOSTASIS IN PREGNANT WOMEN WITH
PREECLAMPSIA
Adizova S.R., Ibrohimova D.B.,
Scientific advisor: d.m.s.
docent Ikhtiyarova G.A.
BukSMI, Department of Obstetrics and Gynecology
Activation of the system of hemostasis in preeclampsia creates a premorbid background for
thrombohemorrhagic complications. Hemostasis disorders increase the risk of severe bleeding during
labor and cesarean section. During surgical interventions against the background of thrombocytopenia
and thrombocytopathy (even with careful stopping of bleeding) bleeding is possible, including delayed
bleeding. The same is observed in coagulation factor deficiency. Activation of the hemostasis system,
which leads to the development of thrombosis, is accompanied by the appearance of specific markers in
the bloodstream, reflecting the degree of increase in the hemostatic potential of the blood. Markers of
platelet activation and markers of coagulation cascade activation are distinguished. The latter include
thrombin-antithrombin complex, fibrin monomer, fibrin peptide A, and D-dimer. However, the
determination of almost all of them, with the exception of D-dimer, can be influenced by blood sampling
technique, platelet admixture, which is also a complicating factor for obtaining adequate and reproducible
results.
Purpose o
f this study is to clarify the amount of D-dimer concentration in pregnant women with
preeclampsia.
Material and methods
. Twenty-six pregnant women with preeclampsia and 15 conditionally healthy
pregnant women were examined. In the study groups, we examined the level of D-dimer, which is known
to be a type of fibrin degradation product (FDP) and a witness to intravascular fibrin formation. Written
informed consent was obtained from all patients. Exclusion criteria were possible causes of elevated D-
dimer: hepatic dysfunction; cancer; renal disease (elevated creatinine level), autoimmune diseases,
human immunodeficiency virus, pancreatitis, insulindependent diabetes mellitus, surgery within the
previous 4 weeks, current infections, fever >38°C (upper respiratory tract infections or other organ
infections, including pyelonephritis, pneumonia). All women were residents of Bukhara region.
Statistical processing of the data was performed using Microsoft Excel.
Results and discussion.
The mean age of the examined women was 25.83±0.56 years. Among them,
16 (61.5%) had severe pre-eclampsia and 10 (38.5%) had mild pre-eclampsia. There was a significant
increase in D-dimer to 870 ng/mL in the moderate preeclampsia group and to 1256 ng/mL in the severe
preeclampsia group, while the control group had an average D- dimer value of 630 ng/mL. Fibrinogen
concentrations were 4.06±0.11 g/L, 4.66±0.11 g/L, and 3.36±0.10 g/L, respectively.
Conclusions
. Preeclampsia in pregnancy leads to a progressive increase in circulating D- dimer. In
preeclampsia, standard coagulation tests are poorly informative. Quantification of D- dimer is appropriate
for detecting coagulation shifts in pregnant women.
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