SHORTENED COAGULATION PROFILE IN PREGNANCY -COMPARATIVE ANALYSIS IN DIFFERENT TRIMESTERS - RETROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE
Dr. Sarika Singh*, Dr. Bhavika Rishi and Dr. Sunita Sharma
Introduction / Background: A state of hypercoagulation and low grade disseminated intravascular coagulation exists during the entire period of pregnancy and immediate postpartum period. While this is beneficial for preventing maternal hemorrhage during pregnancy and delivery, at the same time also predisposes the women for multiple complications (e.g. miscarriages, preeclampsia, intra-uterine growth restriction, etc.). Shortened aPTT (Activated partial thromboplastin time) is a marker of hypercoagulability observed in pregnancy and has been associated with increased incidence of venous thromboembolism (VTE). Materials and methods: This retrospective study was conducted at the Department of Pathology of a tertiary care hospital in North India, including pregnant women who were followed up in the antenatal clinic of the hospital. Objective of the study was to assess the prevalence of shortened Prothrombin time (PT) and aPTT in pregnant women and to further assess the incidence of pre mature rupture of membrane (PROM) and preeclampsia in those with an isolated shortened aPTT, during 3rd trimester and labor. Women with past history of thrombosis, antenatal hemorrhage and bad obstetric history were excluded. Results: Among 173 pregnant women included in the study 71.7% were detected to have a shortened PT, aPTT or both; the commonest abnormality was an isolated shortened aPTT (65/124). Most (83%) of the patients were in their 3rd trimester of pregnancy during which the highest prevalence of shortened aPTT (86%) was seen. Women with a shortened aPTT during 3rd trimester and labor were detected to have a very high incidence of PROM and preeclampsia. Conclusion: There is a high prevalence of shortened PT and aPTT in pregnant women and a shortened aPTT during 3rd trimester and labor is associated with a very high chances of PROM and preeclampsia.
Keywords: Hypercoagulable state, pregnancy, prothrombin time, activated partial thromboplastin time.
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