Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Imoru Momodu Olutayo,Ifedayo Ajayi

doi:10.4172/2329-8790.1000219

Imoru Momodu Olutayo, Ifedayo Ajayi

Open Access

https://doi.org/10.4172/2329-8790.1000219

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Abstract

Aim: Normal pregnancy is associated with haemostatic changes which have been linked to a complex physiological adaptation but these changes return to that of non-pregnant state at about 4 weeks of post-delivery. This study was undertaken to monitor the haemostatic changes during pregnancy and puerperium in North-Western Nigeria. Materials and methods: Ten pregnant women, aged 17-40 years were monitored for haemostatic changes from the first trimester to 6 weeks after delivery between August 2010 and October 2011 at Aminu Kano Teaching Hospital, Kano. Blood samples collected for platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation products (FDP), fibrinogen level, d-dimer, protein C, factors VII and VIII activities were analysed using standard laboratory techniques. Results: There were significantly lower values of platelet count, factor VIII concentration and protein C activity of 275.5 ± 4.14 × 109/L, 93.2 ± 31.6% and 56.7 ± 13.4% during pregnancy compared to 378.5 ± 74.0 × 109/L, 122.5 ± 3.0% and 97.1 ± 14.6% respectively, during puerperium. The values of PT, factor VII concentration, fibrinogen level, FDP and D-dimer concentrations during pregnancy and puerperium showed no significant differences (P>0.05). Factors VII and VIII concentrations increased significantly as gestation advanced (P<0.05). Conclusion: The study concluded that changed values of platelet count, protein C and factor VIII concentrations during pregnancy, normalized at puerperal period while advanced gestation may pose a threat to pregnancy. It is recommended that

Highlights

Normal pregnancy is associated with extensive changes in haemostasis and these changes have been linked to a complex physiological adaptation, which ensures the rapid and effective control of bleeding from the placental site at the time of placental separation while allowing the expansion of the maternal and foetal circulations at the uteroplacental interface during pregnancy [1,2,3]
There were significantly lower values of platelet count, factor VIII concentration and protein C activity of 275.5 ± 4.14 × 109/L, 93.2 ± 31.6% and 56.7 ± 13.4% during pregnancy compared to 378.5 ± 74.0 × 109/L, 122.5 ± 3.0% and 97.1 ± 14.6% respectively, during puerperium
The study concluded that changed values of platelet count, protein C and factor VIII concentrations during pregnancy, normalized at puerperal period while advanced gestation may pose a threat to pregnancy

Summary

Introduction

Normal pregnancy is associated with extensive changes in haemostasis and these changes have been linked to a complex physiological adaptation, which ensures the rapid and effective control of bleeding from the placental site at the time of placental separation while allowing the expansion of the maternal and foetal circulations at the uteroplacental interface during pregnancy [1,2,3] Most of these changes in blood coagulation and ibrinolysis create a state of hypercoagulability [4] which protects the pregnant women from haemorrhage during delivery but predisposes them to thromboembolism [5]. Fibrinogen has been found to increase during pregnancy but gets consumed together with other coagulation factors and platelets during delivery [6] while d-dimer level was reported to increase with each trimester and decrease during puerperium [8,9].

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