Hemostatic changes associated with normal and abnormal pregnancies.

Routine hemostatic laboratory tests lack sensitivity and are of little value in the detection of the pregnancy associated hypercoagulable conditions. Assays for F 1 + 2, AT levels, TAT complex, APC activity, FPA, D-Dimers, tPA, plasminogen, PAI 1, and PAI 2 are more specific for fibrin formation and lysis. Monitoring these tests along with fibrinogen and platelet counts provides important information for the early detection of hemostatic activation and for monitoring the severity of the condition. Early detection and therapy is essential for limiting the deleterious complications of pregnancy. Advances in research, the development of new tests such as the TM assay and gene analysis, as well as highly skilled personnel, are required for the providing of quality pre and postnatal healthcare.