Thrombin generation, D-dimer and protein S in uncomplicated pregnancy.

Abstract:

BACKGROUND:Gestational age-specific reference values are essential for the accurate interpretation of haemostatic tests during pregnancy. METHODS:Our 1-year prospective study included 40 healthy pregnant women with a median age of 30 (range 22-40) years; the subjects were followed in order to establish the gestational age dependent values for endogenous thrombin potential (ETP), D-dimer and protein S (activity and free). RESULTS:During the first trimester 50% of studied women had ETP >100% (reference values out of pregnancy); in the second trimester an ETP over 100% was observed in all women; ETP values remained unchanged during the third trimester. In the first trimester, the median D-dimer concentration of 0.30 mg/L, in the second 0.91 mg/L and in the third of 1.45 mg/L were observed. During the first trimester 14/40 subjects had protein S activity below reference range (<59%, out of pregnancy); the median value of 61.35; interquartile range (IQR) 20.38; in the second 21/37; the median value of 53.1 (IQR 15.65); in the third trimester 28/37 had low level of protein S activity with the median value of 49.0 (IQR 18.8). Free protein S showed a slight decrease from the first trimester; it remained almost stable during the rest of pregnancy, with the equal number of pregnant women with reduced free protein S. CONCLUSIONS:Related to the gestational age, a significant increase of ETP and D-dimer, from the second trimester was observed; the decrease of protein S was observed already from the early pregnancy, with more pronounced variability of protein S activity.

journal_name

Clin Chem Lab Med

authors

Kovac MK,Lalic-Cosic SZ,Dmitrovic JM,Djordjevic VJ,Radojkovic DP

doi

10.1515/cclm-2014-1030

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

1975-9

issue

12

eissn

1434-6621

issn

1437-4331

pii

/j/cclm.ahead-of-print/cclm-2014-1030/cclm-2014-10

journal_volume

53

pub_type

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