Variations of coagulation biochemical markers in normal pregnant women in early and late pregnancy

Q4 Medicine 中华围产医学杂志 Pub Date : 2019-12-16 DOI:10.3760/CMA.J.ISSN.1007-9408.2019.12.006

Ling-ying Kong, Huixia Yang

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Abstract

Objective To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy. Methods The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT), APTT ratio, prothrombin time (PT), PT ratio, prothrombin activity, international normalized ratio, fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014. Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared. In addition, the normal reference values were calculated. Paired t test and sum-rank test were used for statistical analysis. The reference values were presented with P2.5-P97.5. Results In early pregnancy, some coagulation indexes after the seventh weeks were shorter than those before, such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001], but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001] became higher. APTT [(27.5±1.6) vs (31.4±2.4) s, t=24.736, P<0.001], PT [(9.7±0.5) vs (11.0±0.8) s, t=18.647, P<0.001] and TT [(13.3±0.8) vs (14.2±1.0) s, t=9.255, P<0.001] were significantly shorter, while Fib [(4.4±0.5) vs (3.1±0.4) g/L, t=-29.152, P<0.001] was higher in late pregnancy than in early pregnancy. The reference values of APTT, PT, Fib and TT in early pregnancy were 26.5-36.0 s, 9.4-12.4 s, 2.4-4.0 g/L and 12.3-16.4 s, and those in late pregnancy were 25.0-31.2 s, 8.8-10.6 s, 3.4-5.4 g/L and 12.0-14.9 s, respectively. Conclusions The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy. APTT, PT and TT are shorter, while Fib is higher in late pregnancy than in early pregnancy. Key words: Partial thromboplastin time; Prothrombin time; Thrombin time; Fibrinogen; Pregnancy trimester, first; Pregnancy trimester, third

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正常孕妇妊娠早期和晚期凝血生化指标的变化

目的探讨正常孕妇妊娠早期和晚期凝血指标的变化。方法回顾性收集2013年8月至2014年9月在北京大学第一医院分娩的196例正常孕妇妊娠早期和晚期凝血指标，包括活化部分凝血活素时间(APTT)、APTT比值、凝血酶原时间(PT)、PT比值、凝血酶原活性、国际标准化比值、纤维蛋白原(Fib)、凝血酶时间(TT)。比较妊娠早、晚、早7孕周前后这些指标的差异。此外，还计算了正常参考值。采用配对t检验和和秩检验进行统计分析。参考值用p2.5 ~ p97.5表示。结果妊娠早期，7周后部分凝血指标APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001]、TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001]较妊娠前缩短，Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001]增高。APTT[(27.5±1.6)vs(31.4±2.4)s, t=24.736, P<0.001]、PT[(9.7±0.5)vs(11.0±0.8)s, t=18.647, P<0.001]、TT[(13.3±0.8)vs(14.2±1.0)s, t=9.255, P<0.001]在妊娠晚期明显低于妊娠早期，Fib[(4.4±0.5)vs(3.1±0.4)g/L, t=-29.152, P<0.001]明显高于妊娠早期。妊娠早期APTT、PT、Fib、TT参考值分别为26.5 ~ 36.0 s、9.4 ~ 12.4 s、2.4 ~ 4.0 g/L、12.3 ~ 16.4 s，妊娠晚期APTT参考值分别为25.0 ~ 31.2 s、8.8 ~ 10.6 s、3.4 ~ 5.4 g/L、12.0 ~ 14.9 s。结论孕妇凝血指标从妊娠早期开始就有明显变化。APTT、PT、TT较短，而Fib在妊娠后期高于妊娠早期。关键词:部分凝血活酶时间;凝血酶原时间;凝血酶时间;纤维蛋白原;妊娠三个月，第一;妊娠三个月，第三

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来源期刊

中华围产医学杂志 Medicine-Obstetrics and Gynecology

CiteScore

0.70

自引率

0.00%

发文量

4446

期刊介绍： Chinese Journal of Perinatal Medicine was founded in May 1998. It is one of the journals of the Chinese Medical Association, which is supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by Peking University First Hospital. Perinatal medicine is a new discipline jointly studied by obstetrics and neonatology. The purpose of this journal is to "prenatal and postnatal care, improve the quality of the newborn population, and ensure the safety and health of mothers and infants". It reflects the new theories, new technologies, and new progress in perinatal medicine in related disciplines such as basic, clinical and preventive medicine, genetics, and sociology. It aims to provide a window and platform for academic exchanges, information transmission, and understanding of the development trends of domestic and foreign perinatal medicine for the majority of perinatal medicine workers in my country.