Risks of thromboembolic complications in pregnant women with hereditary thrombophilia based on the results of platelet aggregation function study
Background. Hereditary thrombophilia significantly increases the risk of thromboembolic complications and obstetric pathology (miscarriage, preeclampsia, placental insufficiency) in pregnant women. Physiological hypercoagulation during gestation aggravates prothrombotic conditions, which requires timely diagnosis and medical prevention. The study of platelet aggregation function allows to evaluate the cellular mechanisms of thrombus formation, which is especially important for pregnant women with genetic forms of thrombophilia. Objective. Determination of the functional activity of platelets in pregnant women with hereditary thrombophilia and identification of risk factors for thromboembolic complications. Materials and methods. The study included 253 women in the third trimester of pregnancy, divided into three groups: 63 with hereditary thrombophilia (group 1), 144 with threatening premature birth (group 2), 46 with physiologically proceeding pregnancy (group 3). The aggregation function of platelets was assessed by an optical method (aggregatometry) with inducers: ADP (0.5 and 1.5 μmol/l), adrenaline (5.0 μmol/l), collagen (20 μmol/l). The rate, degree and time of aggregation were analyzed. Statistical analysis was carried out using nonparametric criteria. Results. In women of group 1, platelet hyperactivation was detected: increased rate and degree of spontaneous aggregation (5.2% compared to 2.5% in group 3, p<0.001); hyperaggregation with ADP 0.5 μmol/l: rate – 49.0%/min compared to 20.2%/min in group 3 (p<0.001), degree – 71.6% compared to 26.6% in group 3 (p<0.001); hyperaggregation with collagen 20.0 μmol/l: rate – 20.8%/min compared to 5.3%/min in group 3 (p<0.001), degree – 92.2% compared to 80.0% in group 3 (p<0.001); adrenaline-induced aggregation: rate – 17.2%/min compared to 10.7%/min in group 3 (p<0.001). Conclusion. Aggregatometry reveals platelet hyperactivity in pregnant women with hereditary thrombophilia, which correlates with a high risk of thromboembolism. Aggregatometry monitoring allows personalizing medical prevention and improving perinatal outcomes.Kurlovich I.V., Zubovskaya E.T., Peresada O.A., Viktor S.A., Vashchilina T.P.
Keywords
hereditary thrombophilia
platelet aggregation
pregnancy
About the Authors
Ivan V. Kurlovich, Cand. Sci. (Med.), Associate Professor, Deputy Director for Research, Republican Scientific and Practical Center “Mother and Child” of the Ministry of Health of the Republic of Belarus, Minsk, Republic of Belarus; ivan.kurlovich@gmail.com, ORCID: https://orcid.org/0009-0009-7384-8460 (corresponding author)Elena T. Zubovskaya, Cand. Sci. (Med.), Associate Professor, Senior Researcher, Laboratory of Obstetric and Gynecological Pathology, Republican Scientific and Practical Center «Mother and Child» of the Ministry of Health of the Republic of Belarus, Minsk, Republic of Belarus; laigp@medcenter.by, ORCID: https://orcid.org/0009-0002-4781-7854
Olga A. Peresada, Dr. Sci. (Med.), Professor, Professor, Department of Obstetrics and Gynecology, Institute for Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University, Minsk, Republic of Belarus; dr-olga@yandex.by, ORCID: https://orcid.org/0009-0009-5219-3784
Svetlana A. Viktor, Cand. Sci. (Med.), Head of the Laboratory of Obstetric and Gynecological Pathology, Republican Scientific and Practical Center «Mother and Child» of the Ministry of Health of the Republic of Belarus, Minsk, Republic of Belarus; laigp@medcenter.by, ORCID:
https://orcid.org/0009-0002-2932-5514
Tatyana P. Vashchilina, Cand. Sci. (Med.), Associate Professor, Head of the Laboratory of Reproductive Health, Republican Scientific and Practical Center «Mother and Child» of the Ministry of Health of the Republic of Belarus, Minsk, Republic of Belarus; lrz@medcenter.by, ORCID:
https://orcid.org/0009-0009-4964-8071
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