THE STATE OF THE HEMOSTATIC SYSTEM IN PREGNANT WOMEN WITH ARTERIAL HYPERTENSION AGAINST THE BACKGROUND OF IODINE DEFICIENCY
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8795Keywords:
prevention, placental dysfunction, folates.Abstract
The aim of the study – to learn the state of the hemostatic system in pregnant women with arterial hypertension against the background of iodine deficiency.
Materials and Methods. 60 pregnant women, living in iodine deficiency, I group –30 pregnant women with arterial hypertension; the control group consisted of 30 healthy pregnant women, living in conditions of endemic iodine deficiency. The state of the hemostatic system was studied based on the following indices: platelet count (Pl), fibrinogen content (Fg), prothrombin index (PTT), activated partial thromboplastin time (APTT), activated recalcification time (ART), concentration of fibrin / fibrinogen degradation products (FFDP). The received data were processed by statistical method using the computer program Microsoft Excel.
Results and Discussion. According to the data obtained in pregnant women with arterial hypertension against the background of iodine deficiency, the average values of Pl content were almost 23 % lower, compared to KG and were not reliable (p> 0.05). This tendency persisted during the II and III trimesters of pregnancy. In the first trimester of pregnancy, the concentration of Fg in blood plasma in pregnant women in Group I was found to be significantly lower than in CG (p <0.05). Activation of procoagulation tendencies in the I group was accompanied by a significant increase in the PTT. Reduction of APTT, due to increased plasma coagulation potential and the current inclination to hypercoagulation, was observed in most patients in group I. The lowest APTT values among pregnant women with arterial hypertension coincided with the period of the final formation of the fetoplacental complex. Disregulatory changes in the plasma gestational hemostasis at the beginning of gestation in pregnant women in group I were confirmed by the relative extension of ART, which may indicate deeper violations in the plasma hemostasis with an increase in gestational age. Signs of activation of intravascular coagulation due to increased concentration of products of fibrin and fibrinogen degradation (PFFD) were available in pregnant women in the main group from the early gestational age and with an increase in the period of pregnancy, increased significantly.
Conclusions. The state of the system of hemostasis in pregnant women with chronic hypertension against the background of iodine deficiency is characterized by an increase in the plasma coagulation potential, a tendency to hypercoagulation. From the II trimester, in these pregnancies, hypercoagulability is strongly increased, the state of unstable exertion in the hemostasis system, characterized by failure of compensatory mechanisms, and indicating an onset of the clinical form of the first phase of disseminated intravascular coagulation. This may be a prerequisite for the development of placental dysfunction, as a result of placental circulation disorder, accompanied by developmental delay and fetal distress, against which the risk of preeclampsia is sharply increased.
References
Mellina, I.M. (2013). Uskladnennia vahitnosti u zhinok z hipertonichnoiu khvoroboiu: faktory ryzyku i profilaktyka [Complications of pregnancy in women with hypertension: risk factors and prevention]. Visnyk naukovykh doslidzhen – Bulletin of Scientific Research, 1, 50-51 [in Ukrainian].
Alekseeva, L.L. & Fatkulnina, I.B. (2011). Sostoyanie fetoplatsentarnogo kompleksa i iskhody u beremennykh s essentsialnoy arterialnoy gipertenziey [The state of the fetoplacental complex and outcomes in pregnant women with essential hypertension]. Byul. VSNTS SO RAMN – Bulletin of VSNTS SO RAMN, 1, (2), 15-19 [in Russian].
Makatsariya, A.D. (2011). Trombogemorragicheskie oslozhneniya v akushersko- ginekologicheskoy praktike [Thrombohemorrhagic complications in obstetric and gynecological practice]. Moscow [in Russian].
Mustafa, R., Ahmed, S., Gupta, A. & Venuto, R.C. (2012). A comprehensive review of hypertension in pregnancy. J. Pregnancy, 5 (3), 534-538.
(2012). Thromboelastography, thromboe-lastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. Obstetrical and Gynecological Survey, 67, 426-435.
Katz, D. & Beilin, Y. (2015). Disorders of coagulation in pregnancy. British Journal of Anaesthesia, 115 (2), 1175-1188.
Ibeh, N., Okocha, C.E., Aneke, C.J., Onah, C.E., Nwosu, A.O. & Nkwazema, K.A. (2015). Normal pregnancy and coagulation profile: from the first through the third trimester. Nigerian Journal of Medicine, 24, 54-57.
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