Redman C W
Postgrad Med J. 1979 May;55(643):367-71. doi: 10.1136/pgmj.55.643.367.
Coagulation problems in pregnancy are primarily associated with overactivity of the intrinsic clotting system. This accounts for the increased incidence of thrombo-embolism during pregnancy. Where specific obstetric complications cause clotting problems the common underlying feature is usually placental pathology as in abruptio placentae, pre-eclampsia or hydatidiform mole. Abnormal activation of the clotting system is an early, and occasionally the first detectable feature of pre-eclampsia, but there is no evidence that this is a primary change. Therefore the role of anticoagulant treatment in the management of pre-eclampsia remains questionable. A new test for estimating factor VIII consumption is proving to be a sensitive index of early activation of the clotting system and can be used for the diagnosis of early pre-eclampsia.
妊娠期凝血问题主要与内源性凝血系统活性过高有关。这解释了妊娠期血栓栓塞发病率增加的原因。在特定产科并发症导致凝血问题的情况下，常见的潜在特征通常是胎盘病变，如胎盘早剥、子痫前期或葡萄胎。凝血系统的异常激活是子痫前期的早期表现，偶尔也是首个可检测到的特征，但没有证据表明这是原发性变化。因此，抗凝治疗在子痫前期管理中的作用仍存在疑问。一种用于评估因子VIII消耗的新检测方法被证明是凝血系统早期激活的敏感指标，可用于早期子痫前期的诊断。
