open access

https://hdl.handle.net/2115/47215

Pregnancy-induced antithrombin deficiency

英語

pregnancy-induced hypertension

2010-07

Walter de Gruyter

Journal of Perinatal Medicine

38(4)

379-385

OBJECTIVE: Some women exhibit a gradual decline in antithrombin activity during the late stage of pregnancy. This retrospective study was performed to better characterize the laboratory features and water metabolism of such women with pregnancy-induced antithrombin deficiency (PIATD). METHODS: Among 1493 women who gave birth to a singleton infant at our institution, 114 women who developed PIATD and/or pregnancy-induced hypertension (PIH) were reviewed with respect to perinatal changes in laboratory variables (hematocrit value, fibrinogen, fibrinogen degradation product, D-dimer, uric acid, aspartate aminotransferase, lactate dehydrogenase) and body weight. PIATD was defined as a gradual decline in antithrombin activity to ≤ 65% of normal activity levels. One hundred and fourteen women with neither PIATD nor pregnancy-induced hypertension (PIH) and matched for the cesarean delivery rate were selected as a control group. RESULTS: Of the 81 women who developed PIH, 19 (23.4%) also developed PIATD. Thirty-three women developed PIATD in the absence of PIH. Coagulation-fibrinolysis was significantly more enhanced and the postpartum reduction in the hematocrit value was significantly larger in women with PIATD, irrespective of the presence or absence of hypertension, than in women without PIATD. The postpartum decrease in body weight was significantly smaller in women with PIATD, irrespective of the presence or absence of hypertension, than in women without PIATD. CONCLUSIONS: A decrease in antithrombin activity can occur in the absence of hypertension. Even in the absence of hypertension, a decreased plasma volume and enhanced coagulation-fibrinolysis seem to be notable characteristics in women with PIATD. The monitoring of antithrombin activity may be helpful for distinguishing pregnant women with these insidious risks.

学術雑誌論文

Accepted Manuscript

0300-5577