Document Detail

Haemostatic reference intervals in pregnancy.
MedLine Citation:
PMID:  20174768     Owner:  NLM     Status:  MEDLINE    
Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13-20, 21-28, 29-34, 35-42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S, and protein C and in a subgroup of 186 women in addition for prothrombin time (PT), Owren and Quick PT, protein S activity, and total protein S and coagulation factors II, V, VII, VIII, IX, X, XI, and XII. The level of coagulation factors II, V, X, XI, XII and antithrombin, protein C, aPTT, PT remained largely unchanged during pregnancy, delivery, and postpartum and were within non-pregnant reference intervals. However, levels of fibrinogen, D-dimer, and coagulation factors VII, VIII, and IX increased markedly. Protein S activity decreased substantially, while free protein S decreased slightly and total protein S was stable. Gestational age-specific reference values are essential for the accurate interpretation of a subset of haemostatic tests during pregnancy, delivery, and puerperium.
Pal B Szecsi; Maja Jørgensen; Anna Klajnbard; Malene R Andersen; Nina P Colov; Steen Stender
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-19
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  103     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-01     Completed Date:  2010-06-17     Revised Date:  2010-10-07    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  718-27     Citation Subset:  IM    
Department of Clinical Biochemistry, Gentofte Hospital, University of Copenhagen, Denmark.
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MeSH Terms
Antithrombins / metabolism
Biological Markers / blood
Blood Coagulation Factors / metabolism*
Blood Coagulation Tests* / standards
Cohort Studies
Fibrin Fibrinogen Degradation Products / metabolism
Fibrinogen / metabolism
Gestational Age
Partial Thromboplastin Time
Postpartum Period / blood*
Predictive Value of Tests
Pregnancy Complications, Hematologic / blood,  diagnosis*
Protein C / metabolism
Protein S / metabolism
Prothrombin Time
Reference Values
Reg. No./Substance:
0/Antithrombins; 0/Biological Markers; 0/Blood Coagulation Factors; 0/Fibrin Fibrinogen Degradation Products; 0/Protein C; 0/Protein S; 0/fibrin fragment D; 9001-32-5/Fibrinogen

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