Coagulation way of hemostasis in pregnant women and puerperae with pre-eclampsia in whom caesarean section was performed

Aim. To evaluate clinical value of trombodynamics in diagnosing the state of coagulation way of hemostasis in patients with pre-eclampsia in whom caesarean section was performed.

Methods. The study included 66 pregnant women. The study group included 34 of them with moderate to severe pre-eclampsia. During the postoperative period all puerperae received low molecular weight heparin (Dalteparin 2500 IU subcutaneously once a day for 7 days). The comparison group consisted of 32 pregnant women. All of them had scheduled Caesarean section. LMWH was not administered in this group. Thrombodynamics assay was performed in both groups. Blood samples were taken 1-2 hours before cesarean section, 6-12 hours after the surgery before the first injection of anticoagulant if administered, and on day 5 after delivery not less than 24 hours after the injection of anticoagulant.

Results. In the group of patients with pre-eclampsia changes in trombodynamics characteristic for hypercoagulation were revealed: increase of clot growth velocity (V), clot size (CS), its relative density (D) and development of spontaneous clots (Tsp). These numbers become normal slower than in pregnant women and puerperae without pre-eclampsia and with delivery performed surgically.

Conclusion. According to trombodynamics assay, in pregnant women and puerperae with pre-eclampsia, severe hypercoagulation with increased reaction kinetics of clot formation and its physical characteristics were revealed, as well as increase of blood procoagulant potential.