Gerbasi F R, Bottoms S, Farag A, Mammen E
Department of Anesthesiology, Wayne State University, Hutzel Hospital, Detroit, Michigan.
Obstet Gynecol. 1990 Mar;75(3 Pt 1):385-9.
Based on an increased turnover of the hemostatic system, it is believed that pregnancy is associated with "hypercoagulability." However, this hypothesis is based primarily on the measurement of specific coagulation factors or functional tests reflecting hemostatic activity in vitro. Using recent technological advances, we determined the effect of pregnancy on hemostasis in vivo by measuring 11 specific hemostatic indices simultaneously in 28 healthy pregnant women and in 24 nonpregnant female controls. Significant increases were found in fibrinopeptide A (P less than .01), beta thromboglobulin (P less than .001), platelet factor 4 (P less than .02), and fibrin(ogen) degradation products (P less than .001), suggesting increased platelet turnover, clotting, and fibrinolysis. This state of compensated, accelerated intravascular coagulation may be necessary for maintenance of the uterine-placental interface and preparation for the hemostatic challenge of delivery.
基于止血系统周转率的增加，人们认为妊娠与“高凝状态”有关。然而，这一假设主要基于体外特定凝血因子的测量或反映止血活性的功能测试。利用最近的技术进展，我们通过同时测量28名健康孕妇和24名非孕女性对照者的11项特定止血指标，确定了妊娠对体内止血的影响。发现纤维蛋白肽A（P<0.01）、β-血小板球蛋白（P<0.001）、血小板因子4（P<0.02）和纤维蛋白（原）降解产物（P<0.001）显著增加，提示血小板周转率、凝血和纤维蛋白溶解增加。这种代偿性的、加速的血管内凝血状态对于维持子宫-胎盘界面以及为分娩时的止血挑战做准备可能是必要的。
