Changes in fibrin D-dimer, fibrinogen, and protein S during pregnancy.
Summary of "Changes in fibrin D-dimer, fibrinogen, and protein S during pregnancy."
Abstract Background. Pregnancy is a hypercoagulable state with a 5- to 10- fold higher risk of venous thromboembolism. Existing reference intervals for fibrin D-dimer (D-dimer), functional fibrinogen (fibrinogen) and protein S, free antigen (protein S) are based on non-pregnant patients and reference intervals for pregnant patients are warranted. Objectives. The aim of the present study was to contribute to the establishment of reference intervals for D-dimer, fibrinogen and protein S during pregnancy and to discuss the use of the analyses during pregnancy. Methods. We included 55 healthy pregnant women in gestational week 11-17, with normal current pregnancy. Blood samples were collected in gestational weeks 11-17, 21-27 and 34-37. The three plasma parameters D-dimer, fibrinogen and protein S were analysed by STA-R Evolution(®). Results. A significant rise in D-dimer was found from first to second trimester (p < 0.0001) and from second to third trimester (p < 0.0001). The level of fibrinogen rose significantly from second to third trimester (p < 0.0001). Protein S showed a statistically significant fall in the level from first to second trimester (p < 0.0001) and remained stable thereafter. Conclusion. Changes during pregnancy in plasma D-dimer, protein S and fibrinogen were confirmed. Further clinical studies are needed to clarify a clinical useful cut-off point for D-dimer in pregnancy. We suggest careful attention to a low peripartum fibrinogen, since it indicates an increased bleeding risk. We confirmed an earlier suggested lower cut-off point for protein S, during pregnancy.
Affiliation
Department of Clinical Biochemistry, Center of Hemophilia and Thrombosis, Aarhus University Hospital, Skejby.
Journal Details
This article was published in the following journal.
Name: Scandinavian journal of clinical and laboratory investigation
ISSN: 1502-7686
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21190511
- DOI: http://dx.doi.org/10.3109/00365513.2010.545432
Medical and Biotech [MESH] Definitions
Fibrin Fibrinogen Degradation Products
Soluble protein fragments formed by the proteolytic action of plasmin on fibrin or fibrinogen. FDP and their complexes profoundly impair the hemostatic process and are a major cause of hemorrhage in intravascular coagulation and fibrinolysis.
Thrombin Time
Clotting time of PLASMA mixed with a THROMBIN solution. It is a measure of the conversion of FIBRINOGEN to FIBRIN, which is prolonged by AFIBRINOGENEMIA, abnormal fibrinogen, or the presence of inhibitory substances, e.g., fibrin-fibrinogen degradation products, or HEPARIN. BATROXOBIN, a thrombin-like enzyme unaffected by the presence of heparin, may be used in place of thrombin.
Fibrinogens, Abnormal
Fibrinogens which have a functional defect as the result of one or more amino acid substitutions in the amino acid sequence of normal fibrinogen. Abnormalities of the fibrinogen molecule may impair any of the major steps involved in the conversion of fibrinogen into stabilized fibrin, such as cleavage of the fibrinopeptides by thrombin, polymerization and cross-linking of fibrin. The resulting dysfibrinogenemias can be clinically silent or can be associated with bleeding, thrombosis or defective wound healing.
Fibrinogen
Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.
Fibrin Tissue Adhesive
An autologous or commercial tissue adhesive containing FIBRINOGEN and THROMBIN. The commercial product is a two component system from human plasma that contains more than fibrinogen and thrombin. The first component contains highly concentrated fibrinogen, FACTOR VIII, fibronectin, and traces of other plasma proteins. The second component contains thrombin, calcium chloride, and antifibrinolytic agents such as APROTININ. Mixing of the two components promotes BLOOD CLOTTING and the formation and cross-linking of fibrin. The tissue adhesive is used for tissue sealing, HEMOSTASIS, and WOUND HEALING.
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