Changes in coagulogram parameters and acid-base composition of blood in pregnant women with moderate and severe preeclampsia

Abstract

Objective: to conduct a comparative analysis of coagulogram and acid-base composition of blood in pregnant women with moderate and severe preeclampsia (PE) and to assess the impact of the detected disorders on pregnancy outcomes. Material and methods. Group 1 consisted of patients with moderate PE (n=33), group 2 — with severe PE (n=34), and group 3 —women with physiological gestation (n=39). Parameters of coagulogram, acid-base composition of capillary blood of pregnant women (pH, pC02, p02, HC03-act) were determined on the RAPIDLAB 1265 device. Results. An increase in the level of fibrinogen was revealed in group 1 — by 9.9% relative to the indicator of group 3 (p=0.10), in group 2 — by 28.2% (p=0.002) against the background of a shortening of the APTT, respectively by 6.8% (p=0.003) and 9.9% (p<0.001) and a decrease in the number of platelets — by 11.9% (p=0.03) and 27.3% (p<0.001). Changes in the acid-base composition of capillary blood in PE were established: a decrease in HC03-act and p02 with an increase in pC02, which reflect the tendency to develop metabolic acidosis and respiratory alkalosis, more pronounced in group 2. Conclusions. PE is associated with disorders of blood coagulation potential and changes in blood gas composition, more pronounced in severe PE, which contributes to an increase in the frequency of premature birth (with moderate PE — up to 75.8%, severe — up to 100%) and cesarean section (respectively, by 7.7 and 18 times). The measurement of pC02 and p02 levels should be classified as informative and promising tests in terms of differential diagnosis of the severity of PE.