engleski

Coagulation changes during labor and delivery in patients with severe preeclampsia

Objective. The aim of the study was to define the changes in coagulation and fibrinolytic system of healthy pregnant women and severe preeclamptic women during their pregnancy, labour and period after delivery. Study design. In this study 79 pregnant women were analysed during their pregnancy, delivery and postnatal period. Results. Comparing number of platelets in both studied groups, significantly lower number of platelets was found in pregnant women with severe preeclampsia (F=6.1323; p=0.016). Mean fibrinogen value in advanced pregnancy of healthy women was 4.3ą0.85 g/L, with lowest value of 2.85 g/L. Fibrinogen concentration in samples from pregnancies complicated with severe preeclampsia were significantly lower when compared to those from control and it was 3.45ą1.1 g/L (F=14.967; p=0.0002). In control group factors II, V and VIII were elevated in comparison to the studied group. Even though the platelets number has fallen from 264.6ą37.1 during third stage of labour to 187.06ą51.2 in mL, after 1 hour placenta is delivered what is statistically significant. The number of platelets during first stage of labour in studied group was 232.4ą66.9 in ml, and two hours after placenta was delivered it was 167.5ą52 in ml, what is statistically significant lower. Even after 72 hours after placenta was delivered fibrinolytic activity remains increased. Fibrinolysis is even more increased in studied group than in control group during postplacental period. Concentration of FDP significantly increases after delivery of placenta in both groups, but still is significantly higher in those pregnancies complicated with severe preeclampsia. AT-III concentration increases slightly in the early puerperium in both groups. Conclusion. Elevation of FDP, decrease in fibrinogen concentration and activation of fibrinolysis in studied group when compared to the control group are the result of intravascular fibrin deposition which leads to described coagulation changes and fetal intrauterine growth retardation.

blood coagulation; delivery; eclampsia

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