Evaluation of the hemostasis system in pregnant women with placental dysfunction by the method of rotational thromboelastometry

Abstract

The objective: to evaluate the standard indicators of thromboelastometry in pregnant women with placental dysfunction. Materials and methods. Venous blood samples of 26 healthy pregnant women (control group) and 50 patients with placental dysfunction (main group, persons 19–40 years old) were examined. The average gestation period at the time of the study was 29.5±7.2 and 32.9±4.4 weeks, respectively. Standard coagulation tests (coagulogram) and rotational thromboelastometry were performed. Results. Hypercoagulability according to the standard coagulation tests in the women with placental disorders did not correspond to gestational age. No correlation was established between coagulogram parameters, the number of platelets and temogram parameters. According to thromboelastography tests, an increase in clot density is typical for pregnant women with placental dysfunction. Specifically, the results of the fibtem test demonstrated, a statistically significant (p<0.05) increase in clot density at 5, 10, and 20 minutes. Such indicators of fibrinogen synthesis and the fibrin polymerization process indicate the formation of a denser clot in the patients with placental dysfunction. In addition, the MCF indicator, which informs about the maximum density of the clot, is significantly higher in the pregnant women with placental dysfunction compared to the control group. Conclusions. Disorders of coagulation homeostasis in the form of clot formation of increased density play an important role in the pathogenesis of placental dysfunction. This is one of the causes of hemodynamic disorders in the utero-placental and feto-placental blood flow. Thromboelastography, in contrast to the basic coagulation tests of the standard coagulogram, is a more informative method of assessment the coagulation ability of blood in the pregnant women with placental dysfunction.