Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia
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Lalić-Cosić, SanjaDopsaj, Violeta
Kovač, Mirjana
Pruner, Iva
Littmann, Karin
Mandić-Marković, Vesna
Miković, Zeljko
Antović, Aleksandra
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Introduction Haemostatic balance shifted towards hypercoagulability in normal pregnancy is even more pronounced in pre-eclampsia (P-EC). The aim of this study was to analyse haemostatic disturbances and fibrin clot properties in women with pre-eclampsia and to investigate their association with maternal and foetal outcomes. Methods Forty-six pregnant women diagnosed with pre-eclampsia were included in the study, with blood sampling done on the morning following admission to hospital, as well as after delivery (mean duration 4.8 days). Two global haemostatic assays-endogenous thrombin potential (ETP) and assay of overall haemostatic potential (OHP)-were employed, including fibrin clot turbidity measurements and scanning electron microscopy (SEM) of representative samples. Results Three thrombin generation parameters (ETP, t_lag and peak height) and OHP were significantly increased in pre-eclampsia compared with controls, whereas overall fibrinolytic potential (OFP-determined as a parame...ter of the OHP assay) had significantly lower values. Clot lysis time was significantly prolonged in patients with pre-eclampsia. In the pre-eclamptic group after delivery, we observed a significant elevation in the peak height and a reduction in the time to peak and OFP compared with values before delivery. Pre-eclamptic patients with renal complications had significantly higher values for ETP, peak height and D-dimer. Turbidity measurements and SEM revealed dense fibrin structure in patients with pre-eclampsia. Conclusion Patients with pre-eclampsia have enhanced coagulation and impaired fibrinolysis before, and even after, delivery. In particular, the presence of multi-organ dysfunction, such as renal dysfunction, may be associated with increased thrombin generation in pre-eclampsia.
Keywords:
pre-eclampsia / overall haemostatic potential / haemostasis / fibrin structure / endogenous thrombin potentialSource:
International Journal of Laboratory Hematology, 2020, 42, 3, 322-330Publisher:
- Wiley, Hoboken
DOI: 10.1111/ijlh.13183
ISSN: 1751-5521
PubMed: 32190981
WoS: 000520544100001
Scopus: 2-s2.0-85082040715
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Institut za molekularnu genetiku i genetičko inženjerstvoTY - JOUR AU - Lalić-Cosić, Sanja AU - Dopsaj, Violeta AU - Kovač, Mirjana AU - Pruner, Iva AU - Littmann, Karin AU - Mandić-Marković, Vesna AU - Miković, Zeljko AU - Antović, Aleksandra PY - 2020 UR - https://imagine.imgge.bg.ac.rs/handle/123456789/1390 AB - Introduction Haemostatic balance shifted towards hypercoagulability in normal pregnancy is even more pronounced in pre-eclampsia (P-EC). The aim of this study was to analyse haemostatic disturbances and fibrin clot properties in women with pre-eclampsia and to investigate their association with maternal and foetal outcomes. Methods Forty-six pregnant women diagnosed with pre-eclampsia were included in the study, with blood sampling done on the morning following admission to hospital, as well as after delivery (mean duration 4.8 days). Two global haemostatic assays-endogenous thrombin potential (ETP) and assay of overall haemostatic potential (OHP)-were employed, including fibrin clot turbidity measurements and scanning electron microscopy (SEM) of representative samples. Results Three thrombin generation parameters (ETP, t_lag and peak height) and OHP were significantly increased in pre-eclampsia compared with controls, whereas overall fibrinolytic potential (OFP-determined as a parameter of the OHP assay) had significantly lower values. Clot lysis time was significantly prolonged in patients with pre-eclampsia. In the pre-eclamptic group after delivery, we observed a significant elevation in the peak height and a reduction in the time to peak and OFP compared with values before delivery. Pre-eclamptic patients with renal complications had significantly higher values for ETP, peak height and D-dimer. Turbidity measurements and SEM revealed dense fibrin structure in patients with pre-eclampsia. Conclusion Patients with pre-eclampsia have enhanced coagulation and impaired fibrinolysis before, and even after, delivery. In particular, the presence of multi-organ dysfunction, such as renal dysfunction, may be associated with increased thrombin generation in pre-eclampsia. PB - Wiley, Hoboken T2 - International Journal of Laboratory Hematology T1 - Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia EP - 330 IS - 3 SP - 322 VL - 42 DO - 10.1111/ijlh.13183 ER -
@article{ author = "Lalić-Cosić, Sanja and Dopsaj, Violeta and Kovač, Mirjana and Pruner, Iva and Littmann, Karin and Mandić-Marković, Vesna and Miković, Zeljko and Antović, Aleksandra", year = "2020", abstract = "Introduction Haemostatic balance shifted towards hypercoagulability in normal pregnancy is even more pronounced in pre-eclampsia (P-EC). The aim of this study was to analyse haemostatic disturbances and fibrin clot properties in women with pre-eclampsia and to investigate their association with maternal and foetal outcomes. Methods Forty-six pregnant women diagnosed with pre-eclampsia were included in the study, with blood sampling done on the morning following admission to hospital, as well as after delivery (mean duration 4.8 days). Two global haemostatic assays-endogenous thrombin potential (ETP) and assay of overall haemostatic potential (OHP)-were employed, including fibrin clot turbidity measurements and scanning electron microscopy (SEM) of representative samples. Results Three thrombin generation parameters (ETP, t_lag and peak height) and OHP were significantly increased in pre-eclampsia compared with controls, whereas overall fibrinolytic potential (OFP-determined as a parameter of the OHP assay) had significantly lower values. Clot lysis time was significantly prolonged in patients with pre-eclampsia. In the pre-eclamptic group after delivery, we observed a significant elevation in the peak height and a reduction in the time to peak and OFP compared with values before delivery. Pre-eclamptic patients with renal complications had significantly higher values for ETP, peak height and D-dimer. Turbidity measurements and SEM revealed dense fibrin structure in patients with pre-eclampsia. Conclusion Patients with pre-eclampsia have enhanced coagulation and impaired fibrinolysis before, and even after, delivery. In particular, the presence of multi-organ dysfunction, such as renal dysfunction, may be associated with increased thrombin generation in pre-eclampsia.", publisher = "Wiley, Hoboken", journal = "International Journal of Laboratory Hematology", title = "Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia", pages = "330-322", number = "3", volume = "42", doi = "10.1111/ijlh.13183" }
Lalić-Cosić, S., Dopsaj, V., Kovač, M., Pruner, I., Littmann, K., Mandić-Marković, V., Miković, Z.,& Antović, A.. (2020). Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia. in International Journal of Laboratory Hematology Wiley, Hoboken., 42(3), 322-330. https://doi.org/10.1111/ijlh.13183
Lalić-Cosić S, Dopsaj V, Kovač M, Pruner I, Littmann K, Mandić-Marković V, Miković Z, Antović A. Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia. in International Journal of Laboratory Hematology. 2020;42(3):322-330. doi:10.1111/ijlh.13183 .
Lalić-Cosić, Sanja, Dopsaj, Violeta, Kovač, Mirjana, Pruner, Iva, Littmann, Karin, Mandić-Marković, Vesna, Miković, Zeljko, Antović, Aleksandra, "Evaluation of global haemostatic assays and fibrin structure in patients with pre-eclampsia" in International Journal of Laboratory Hematology, 42, no. 3 (2020):322-330, https://doi.org/10.1111/ijlh.13183 . .