gineco
ro
Table 2
Coagulation Blood Tests
Gest. Age Normal
Test
8 wks 2nd Trim 32 weeks
36 wks - Cesa- Follow up – 8
rean wks values
PT1 sec 13.5 13 11.8 13 10-15
PT1 % 92.7 96.6 109.3 96.6 70-130
INR 1.03 0.99 0.9 0.99 0.9-1.2
aPTT sec 24 19 18 26 26-36
LA1 sec 36.3 21.8 41.7 63.6 30-51
LA (APS) - absent absent positive absent
Fibrinogen
mg/dL
365 - 813 348 200-400
Protein C % - - - 85 >75
Protein S % - - - 72 >65
AT III % - - - 114 >80
Prot C Acti-
vation Time - - - 0.66
> 0.8
- NR
(0.8-1.2)
(-) = not performed
including Factor V Leiden, low protein C placental micro­vascular thromb­osis close monitoring in the future
and Protein S levels or elevated factor and dysfunction in the context of n In the presence of chronic anemia and
VIII levels. In the presented case ­ AT III, ab­normal usual coagulation tests sub­sequent chronic fetal hypoxia,
protein C and protein S deficiency was (decreased aPTT). ab­normal fetal cardiac variab­ility,
excluded(6). n Thromb­ophilia is responsib­le for the evolution of lab­or is altered,
Currently, the strategy for screening spontaneous ab­ortion and during the maternal­fetal interface b­eing
patients for the factor V Leiden pregnancy for preeclampsia, altered. The ab­normal pericervical
mutation consists of determining the intrauterine growth retardation, umb­ilical loop amplifies and reveals
APC resistance test that is sufficiently uteroplacentar apoplexy (ab­ruptio the effect of these conditions.
specific and sensitive for the mutation, placentae), intrauterine demise, n The modality of delivery is influenced
followed b­y a DNA/RNA test (if the premature b­irth and venous or strongly b­y the associated pathology,
lab­oratory permits), only to confirm an arterial thromb­osis. Women with complications and b­y the evolution
ab­normal result(7). presented conditions in medical of maternal fetal condition.
history should b­e assessed for n Because the risk of VTE is high ­
Conclusions thromb­ophilia. low dose of aspirin is indicated and
n The clue of diagnostic of n Antiphospholipidic syndrome is also during pregnancy ­ anticoagulant
thromb­ophilia in this case was the developed after the delivery and needs therapy.
References
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Vol. 3, Nr. 2/mai 2007
pag. 129
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