Department of Obstetrics, Gynecology, and Reproductive Sciences, Fletcher Allen Health Care/University of Vermont, Burlington, USA.
Am J Obstet Gynecol. 2012 Aug;207(2):135.e1-6. doi: 10.1016/j.ajog.2012.05.027. Epub 2012 Jun 11.
Normal pregnancy results in a prothrombotic state. Studies that have investigated the capacity of pregnant women to generate thrombin are limited. Our aim was to evaluate thrombin generation longitudinally from the preconception period, through pregnancy, and after pregnancy.
We evaluated young, healthy nulligravid women (n = 20) at 4 time points and compared the data with 10 control women at 2 time points. Coagulation was initiated with tissue factor in contact pathway inhibited plasma, and thrombin generation was determined in the presence of a fluorogenic substrate.
The maximum level and rate of thrombin generation increased during pregnancy; the highest level and rate occurred in late pregnancy compared with prepregnancy (P < .001). Subsequently, thrombin generation decreased in the postpregnancy samples that included maximum level, rate, and area under the curve (P < .001).
Our data provide evidence for an increase in tissue factor-dependent thrombin generation with pregnancy progression, followed by a return to prepregnancy thrombin levels.
正常妊娠会导致血栓形成倾向。研究孕妇生成凝血酶的能力的研究有限。我们的目的是从受孕前、妊娠期间和产后期间进行纵向评估凝血酶生成。
我们评估了 20 名年轻、健康的初产妇在 4 个时间点,并将数据与 10 名在 2 个时间点的对照妇女进行了比较。凝血在接触途径抑制的组织因子存在下启动,并且在存在荧光底物的情况下确定凝血酶生成。
在妊娠期间,凝血酶生成的最大水平和速率增加;与受孕前相比,在妊娠晚期达到最高水平和速率(P<.001)。随后,包括最大水平、速率和曲线下面积在内的产后样本中的凝血酶生成减少(P<.001)。
我们的数据提供了证据,表明随着妊娠的进展,组织因子依赖性凝血酶生成增加,随后恢复到妊娠前的凝血酶水平。