The course of pregnancy and blood coagulation system

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Pregnancy represents the procoagulant state, giving rise in the high prevalence rate of thrombotic complications. An imbalance between coagulation and anticoagulation systems of blood during pregnancy can lead to the development of pre-eclampsia, intrauterine growth retardation, preterm labor, premature rupture offetal membranes and fetal death. These complications are mostly caused by the impaired generation of thrombin as well as changes in the concentration and activity of tissue factor TFPI (tissue factor pathway inhibitor), TAT III complex and protein Z. Nevertheless, it should be noted that the thrombotic complications during pregnancy depend not on the elevation of the concentrations of specific coagulation factors or lack of the activity of anticoagulant proteins, but on the shift in the whole system toward the procoagulant state. These disorders most of all lead to thromboses ofplacental vessels, causing disorders ofperfusion of the affected area. Placental pathology can develop as from the maternal as from the fetal side. Despite the fact that changes in the blood coagulation system occur from the very beginning of pregnancy, and often are adaptive in nature, i.e., do not require special medical intervention, the prompt diagnosis and treatment of hemostatic disorders as main pathogenetic link in the development of thrombosis is extremely important.

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About the authors

A. V Murashko

I.M. Sechenov First Moscow State Medical University; V.F. Snegirev Clinic of Obstetrics and Gynecology

Moscow, 119991, Russian Federation

Yuliya S. Drapkina

I.M. Sechenov First Moscow State Medical University; V.F. Snegirev Clinic of Obstetrics and Gynecology

Moscow, 119991, Russian Federation
MD, resident physician of the Department of Obstetrics and Gynecology No 1, Medical Faculty of the I.M. Sechenov First Moscow State Medical University

N. S Koroleva

I.M. Sechenov First Moscow State Medical University; V.F. Snegirev Clinic of Obstetrics and Gynecology

Moscow, 119991, Russian Federation


  1. Мурашко А.В., Кумыкова З.Х. Хроническая венозная недостаточность и беременность. Гинекология. 2007; 9 (1): 50-2.
  2. Ищенко А.И., Александров Л.С., Никонов А.П., Харнас С.С., Соколина И.А., Каптильный В.А., Белова А.В. Редкие формы тромботических осложнений в акушерской практике. Архив акушерства и гинекологии им. В.Ф. Снегирева. 2014; 1 (2): 50-4.
  3. Соколян А.В., Мурашко А.В., Кречетова Л.В., Зиганшина М.М., Сухих Г.Т. Значение ангиогенного фактора роста в патогенезе гестоза у беременных с варикозной болезнью. Бюл. экспер. биол. 2008; 145 (4): 464-6.
  4. Bar J., Schreiber L., Ben-Haroush A., Ahmed H., Golan A., Kovo M. The placental vascular component in early and late intrauterine fetal death. Thromb. Res. 2012; 130: 901-5.
  5. Joe D. Coagulation with arrows for negative and positive feedback. UCSD Clinical Chemistry conferences on 14 and 21 October 2014.
  6. Kovo M., Schreiber L., Ben-Haroush A., Gold E., Golan A., Bar J. The placental component in early-onset and late-onset preeclampsia in relation to fetal growth restriction. Prenat. Diagn. 2012; 32: 632-7.
  7. Ogge G., Chaiworapongsa T., Romero R., Hussein Y., Kusanovic J.P., Yeo L. et al. Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia. J. Perinat. Med. 2011; 39: 641-52.
  8. Simioni P., Campello E. Haemostatic changes in pregnancy. Rev. Hlth Care. 2013; 4 (3s): 31.
  9. Jeremiah Z.A., Adias T.C., Opiah M., George S.P., Mgbere O. et al. Elevation in D-dimer concentrations is positively correlated with gestation in normal uncomplicated pregnancy. Int. J. Womens Hlth. 2012; 4: 437-43.
  10. Hui C., Lili M., Libin C., Rui Z., Fang G. et al. Changes in coagulation and hemodynamics during pregnancy: a prospective longitudinal study of 58 cases. Arch. Gynecol. Obstet. 2012; 285: 1231-6.
  11. Клементе Апумайта Х.М., Пак С.В., Гречканев Г.О., Зуев В.М., Сидорова И.С., Мурашко А.В. и др. Новый метод прогнозирования, диагностики и контроля эффективности терапии хронической плацентарной недостаточности. Современные технологии в медицине. 2010; (2): 50-2.
  12. Murashko A.V., Ishenko A.I., Magomedova Sh.M., Didikin S.S., Zinovyeva L.V., Pavlova L.A. et al. Experimental treatment of placental insufficiency in animal model (by IGF-1). Am. J. Clin. Med. Res. 2016; 4 (2): 34-7. doi: 10.12691/ajcmr-4-2-4
  13. Szecsi P.B., Jørgensen M., Klajnbard A., Andersen M.R., Colov N.P., Stender S. Haemostatic reference intervals in pregnancy. Thromb. Haemost. 2010; 103: 718-27.
  14. Thiruvenkatarajan V., Pruett A., Adhikary S.D. Coagulation testing in the perioperative period. Indian J. Anaesth. 2014; 58: 565-72.
  15. Chandler W.L. Emergency assessment of haemostasis in the bleeding patient. Int. J. Lab. Hematol. 2013; 35: 339-43.
  16. Van Rheenen-Flach L.E., Zweegman S., Boersma F., Lenglet J.E., Twisk J.W.R., Bolte A.C. A prospective longitudinal study on rotation thromboelastometry in women with uncomplicated pregnancies and postpartum. Aust. N. Z. J. Obstet. Gynaecol. 2013; 53: 32-6.
  17. Quarterman C., Shaw M., Johnson I., Agarwal S. Intra- and inter-centre standartisation of thromboelastography. Anaesthesia. 2014; 69: 883-90.
  18. Harr J.N., Moore E.E., Ghasabyan A. et al. Functional fibrinogen assay indicates that fibrinogen is critical in correcting abnormal clot strength following trauma. Shock. 2014; 39: 45-9.
  19. Caughey A.B., Cahill A.G., Guise J.M., Rouse D. Safe prevention of the primary cesarean delivery. Am. J. Obstet. Gynecol. 2014; 210: 179-93.
  20. Lipe B.C., Dumas M.A., Ornstein D.L. Von Willebrand disease in pregnancy. Hematol. Oncol. Clin. N. Am. 2011; 25: 335-58.
  21. Silver R.M., Major H. Maternal coagulation disorders and postpartum hemorrhage. Clin. Obstet. Gynecol. 2010; 53: 252-64.
  22. Hedner U. Recombinant activated factor VII: 30 years of research and innovation. Blood Rev. 2015; 29 (Suppl. 1): S4-8.
  23. Basaran A., Basaran M., Basaran B., Sen C., Martin J. Controversial clinical practices for patients with preeclampsia or HELLP syndrome: a survey. J. Perinat. Med. 2015; 43: 61-6.



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