Hryshchenko V. Changes in clinical and laboratory parameters of the hemostasis system in thrombophilia in pregnant women and improvement of the algorithm for their control when taking antiplatelet agents

Pregnancy is a risk factor for the development of thrombophilic conditions.Thrombophilia (TF) during pregnancy is a pathological condition that develops as a result of hereditary or acquired anomalies in the hemostasis system and is characterized by a predisposition to the development of thrombosis. The gestational period is accompanied by physiological hypercoagulability and increases the risk of thrombosis by 5 to 6 times, which contributes to the realization of previously asymptomatic TF. The main changes in hemostasis during pregnancy include: an increase in platelet activity, an increase in the procoagulant properties of the endothelium, an increase in the content of coagulation factors, and a decrease in anticoagulant activity. In the conditions of maternal and fetal TF, there is a violation of implantation, as well as trophoblast proliferation, placentation and fetal growth, the development of systemic endothelial dysfunction, activation of the pro-inflammatory response and, as a result, conditions are created for the development of complications during childbirth. TF of various origins is dangerous for both the life of the mother and the fetus. Most often, during pregnancy, a woman does not suspect such an ailment and learns about the diagnosis after a comprehensive examination. The intravascular system of hemostasis against the background of a thrombophilic state is clinically manifested by thrombosis and complications during pregnancy, therefore, timely determination of the violation of various links of the hemostasis system will help to correctly select treatment, which will further reduce the risk of developing TF during pregnancy. Currently, there is no reliable and effective mechanism for assessing the risk of thromboembolic events, which is necessary to select adequate antithrombotic therapy. In view of the above, an urgent issue is the creation of a protocol for laboratory studies of the hemostasis system in pregnant women with thrombophilic disorders of various origins during the first trimester of pregnancy to avoid the development of complications during pregnancy. Thus, the purpose of our study was to optimize diagnostic approaches to determining disorders of the hemostasis system in pregnant women during the first trimester with thrombophilic disorders of various origins against the background of taking antiplatelet agents. The object of the study is the clinical and laboratory characteristics of the hemostasis system of pregnant women with thrombophilia of various genesis. The subject of the study was: the value of the coagulogram, D-dimer and platelet aggregation.