Thromb Haemost 2008; 99(02): 331-337
DOI: 10.1160/TH07-05-0359
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Calibrated automated thrombin generation in normal uncomplicated pregnancy

Andrea Rosenkranz
1   Department of Pediatrics
,
Michael Hiden
1   Department of Pediatrics
,
Bettina Leschnik
1   Department of Pediatrics
,
Weiss Eva-Christine
2   Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
,
Dietmar Schlembach
2   Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
,
Uwe Lang
2   Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
,
Siegfried Gallistl
1   Department of Pediatrics
,
Wolfgang Muntean
1   Department of Pediatrics
› Author Affiliations
Further Information

Publication History

Received: 18 May 2007

Accepted after major revision: 05 January 2007

Publication Date:
24 November 2017 (online)

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Summary

Pregnancy is associated with substantial changes in the haemostatic system and a six-fold higher incidence of venous thromboembolism. Conventional global tests, such as prothrombin time and activated partial thromboplastin time, do not definitely detect this hypercoagulable condition. We investigated whether the changes in haemostatic system during pregnancy are reflected in the calibrated automated thrombography (CAT). Thrombin generation was measured in platelet-poor plasma (PPP) of 150 healthy pregnant women without any pregnancy associated diseases by means of CAT. In addition, prothrombin (FII), antithrombin (AT), protein S, protein C, tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), thrombin-antithrombin complex (TAT), and prothrombin fragments 1+2 (F1+2) were measured. Endogenous thrombin potential (ETP) and peak of thrombin generation increased significantly with gestational weeks, while lag time and time to peak remained unchanged. A significant increase of PAI-1,TFPI,F1+2 and TAT as well as a significant decrease of free protein S, protein S antigen, and protein S activity was observed. Levels of AT and protein C remained stable during pregnancy. Division of population in trimester of pregnancy and analysis of differences between the trimesters showed rather similar results. Our study shows that endogenous thrombin potential does increase with duration of normal uncomplicated pregnancy. Whether parameters of continuous thrombin generation will correlate with thrombembolic disease remains to be shown.