Continuous Coagulation and Fibrinolysis During Normal Pregnancy in Western Siberia

Abstract

The human body in northern latitudes is most vulnerable to various factors. In these conditions, many functional systems move to a new level of adaptive abilities, which affect the biochemical activity, especially during pregnancy. The formation mechanisms of various shifts in the coagulation system in pregnancy have not been fully clarified. The purpose of this paper was to study continuous coagulation and fibrinolysis in pregnant women living in Western Siberia. Materials and Methods. We evaluated parameters of continuous coagulation and fibrinolysis (levels of soluble fibrin monomer complexes (SFMC), D-dimers, plasminogen, and time of XIIa-dependent clot lysis) in the blood plasma of 100 women living in Khanty-Mansiysk. They were divided into two groups: control (non-pregnant women) – 50 subjects; pregnant women – 50 subjects. Results. Gestation was shown to increase thrombinogenesis and fibrinolytic potential of the blood. Statistically significant changes in the parameters (in dynamics from 1st to 3rd trimester) were revealed. SFMC in the blood of pregnant women increased by 114 % (1st trimester), 148 % (2nd trimester) and 166 % (3rd trimester) compared with the control. Further, an increase in XIIadependent clot lysis time by 156 % in the 2nd trimester and by 179 % in the 3rd trimester, compared with the control, was observed, as well as an increase in D-dimer level (threefold in the 2nd trimester and by the factor of 4.8 in the 3rd trimester). The increase in fibrinolytic potential of the blood during pregnancy is evidenced by the increase in plasminogen levels, compared with the control: by 31 % in the 2nd and by 39.5 % in the 3rd trimester. Direct positive correlations were established: strong correlation between SFMC level and trimester; moderate correlation between D-dimer level and trimester, plasminogen activity and trimester, as well as duration of XIIa-dependent fibrinolysis and trimester.