Document Detail


Coagulation index to distinguish severe preeclampsia from normal pregnancy.
MedLine Citation:
PMID:  12536338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to establish a new coagulation index to distinguish severe preeclampsia from normal pregnancy using optimal coagulation parameters. The difference between platelet counts in early gestation and before delivery (DeltaPlt = [platelet counts before delivery] - [platelet counts in early gestation]) was calculated as an index of changes in platelet counts. Antithrombin (AT) activity, thrombin-antithrombin (TAT) complex, fibrin degradation products (FDP) D-dimer, and DeltaPlt were investigated in 72 cases of normal pregnant women in the third trimester of pregnancy and 56 cases of severe preeclampsia. The new coagulation index was calculated using multivariate logistic regression analysis. As a result, in a case using four parameters, the following formula was obtained: Y = (-0.019 x AT activity) + (0.067 x TAT) + (0.067 x D-dimer) + (-0.064 x DeltaPlt) + 0.706. According to this formula, coagulation indices in normal pregnant women and in patients with severe preeclampsia were -0.77 +/- 0.51 and 1.41 +/- 1.56, respectively (p < 0.0001). Among patients with severe preeclampsia, coagulation and fibrinolysis disorders before delivery were typical in patients terminated by cesarean section (coagulation index = 1.62 +/- 1.66) compared with those with successful vaginal delivery (coagulation index = 0.52 +/- 0.34) (p < 0.05). These facts suggest that an excessive hypercoagulable state is associated with the termination of pregnancy resulting from the aggravation of preeclampsia. From the viewpoint of coagulation and fibrinolysis disorders, the predictive value in order to decide the optimal time for the termination of pregnancy could be recommended when the coagulation index exceeded 1.20.
Authors:
Takao Kobayashi; Kazuhiro Sumimoto; Naoki Tokunaga; Motoi Sugimura; Tomizo Nishiguchi; Naohiro Kanayama; Toshihiko Terao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  28     ISSN:  0094-6176     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-01-21     Completed Date:  2003-06-25     Revised Date:  2006-03-07    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  495-500     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu City, Shizuoka, 431-3192 Japan. tkoba@hama-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Antithrombins / metabolism
Blood Coagulation*
Blood Coagulation Tests / methods
Case-Control Studies
Female
Fibrin Fibrinogen Degradation Products / metabolism
Fibrinolysis
Humans
Labor, Induced
Multivariate Analysis
Platelet Count
Pre-Eclampsia / blood*,  diagnosis,  therapy
Pregnancy
Thrombin / metabolism
Time Factors
Chemical
Reg. No./Substance:
0/Antithrombins; 0/Fibrin Fibrinogen Degradation Products; EC 3.4.21.5/Thrombin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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