Coagulation and Fibrinolysis in Pregnancy Complicated by Intrauterine Growth Retardation

Abstract

In a prospective study, blood from women in the 19th and 32nd week of pregnancy was analyzed for fibrinogen, prothrombin complex (P & P), F, V, F VIII:C, F VIIIR:Ag, the VIIIR:Ag/VIII:C ratio, F IX, F XII, F XIII, antithrombin III, alpha 2-macroglobulin, alpha 1-antitrypsin, alpha 2-antiplasmin, the inhibitor of plasminogen activation and fibrinogen degradation products. In normal pregnancies all the coagulation factors except F XIII were markedly increased, as were alpha 1-antitrypsin and the inhibitor of plasminogen activation. Pregnancy did not influence the levels of antithrombin III, alpha 2-macroglobulin or alpha 2-antiplasmin. Peripheral blood from women with growth retarded fetuses differed in that the levels of P & P, F XII (in the 19th week) and the inhibitor of plasminogen activation (in the 19th and 32nd weeks) were lower. The level of F XIII was higher in the 32nd week. A low grade activation of the coagulation system is suggested as one possible factor in the pathogenesis of intrauterine growth retardation, which emphasized the value of heparin treatment in certain cases with this syndrome.