Epstein Kira L, Hart Kelsey A, Chakravarty Ella J, Giguère Steeve
Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA 30605, USA.
Animals (Basel). 2025 Jun 20;15(13):1822. doi: 10.3390/ani15131822.
During pregnancy and the peripartum period in women, hypofibrinolysis and hypercoagulation minimize excessive hemorrhage risk during parturition. While hypercoagulation is documented in peripartum mares, hypofibrinolysis is not. This study aimed to characterize and compare the fibrinolytic potential of healthy, non-pregnant mares and peripartum mares using tissue-factor (TF)-activated, tissue-plasminogen-activator (tPA)-modified thromboelastography (TEG). TF-activated TEG modified with tPA (500 and 650 U/mL) was performed on plasma samples from 9 pregnant mares at 3, 2, and 1 month pre-partum and 1, 7, and 30 days post-partum, as well as on time-matched samples from 6 non-pregnant mares. At both tPA concentrations, there were relative increases in clot strength [MA] and changes in lysis parameters consistent with hypofibrinolysis (increased CL30 and decreased Ly30) in the pregnant mares compared to the non-pregnant mares. The differences were most frequently detected 1 month pre-partum and at 1 and 7 days post-partum, providing preliminary evidence suggesting pregnant mares are hypofibrinolytic during late gestation and the early post-partum period. However, our small sample size, the unexpected changes in fibrinolysis in the non-pregnant mares over time, and the inconsistent performance of the assay indicate a need for a larger study after further assay optimization to confirm the results. Further investigations of the tPA-modified TEG assay and fibrinolysis in clinical cases are warranted.
在女性怀孕和围产期,纤维蛋白溶解功能减退和血液高凝状态可将分娩时过度出血的风险降至最低。虽然围产期母马存在血液高凝状态已有文献记载,但纤维蛋白溶解功能减退的情况却未见报道。本研究旨在使用组织因子(TF)激活、组织型纤溶酶原激活剂(tPA)改良的血栓弹力图(TEG)来表征和比较健康非孕母马和围产期母马的纤维蛋白溶解潜能。对9匹怀孕母马在产前3个月、2个月和1个月以及产后1天、7天和30天的血浆样本,以及6匹非孕母马的时间匹配样本,进行了用tPA(500和650 U/mL)改良的TF激活TEG检测。在两种tPA浓度下,与非孕母马相比,怀孕母马的血凝块强度[MA]相对增加,且溶解参数变化符合纤维蛋白溶解功能减退(CL30增加,Ly30降低)。这些差异最常出现在产前1个月以及产后1天和7天,这提供了初步证据,表明怀孕母马在妊娠晚期和产后早期存在纤维蛋白溶解功能减退。然而,我们的样本量较小,非孕母马的纤维蛋白溶解功能随时间出现意外变化,以及该检测方法性能不一致,这表明在进一步优化检测方法后需要进行更大规模的研究以确认结果。有必要对tPA改良的TEG检测方法以及临床病例中的纤维蛋白溶解功能进行进一步研究。