Author/Editor		Urlep-Šalinović, Vera
Title		Laboratorijska diagnostika hemostatskih motenj v porodništvu
Type		članek
Source		In: Bricl I, Lampreht N, editors. Transfuzijska medicina v porodništvu. Zbornik strokovnih prispevkov 6. podiplomski seminar Zdravljenje s krvjo; 2004 dec 3-4; Portorož. Ljubljana: Zavod Republike Slovenije za transfuzijsko medicino,
Publication year		2004
Volume		str. 59-66
Language		slo
Abstract		Background. Normal pregnancy is connected with hypercoagulability due to an increase in coagulation, diminished function of inhibitors and diminished fibrinolytic activity. Hemorrhages occur commonly in the third trimester, during delivery or immediately after delivery. Hemostatic disorders, disseminated intravascular coagulation (DIC) being the most frequent, occur in the following pathologic conditions: preeclampsia, eclampsia, placenta previa, placental abruption, sepsis, amniotic fluid embolism, retained dead fetus, and HELLP (hemolytic anemia, elevated liver enzymes, low platelets) syndrome. DIC is a syndrome resulting in multiple organ failure due to mycrovascular thrombosis and severe bleeding due to consumption of coagulation factors and platelets as well as secondary activation of fibrinolysis. The mechanism of coagulation system activation is a result of the release of placental enzymes, amniotic fluid or necrotic fetal tissue factor. Depending on the degree of coagulation system activation, the hemostatic tests characteristic of DIC show a slightly or a very prolonged prothrombin time, prolonged thrombin time, prolonged activated thromboplastin time, decreased fibrinogen, decreased coagulation factors II, V and VIII, decreased antithrombin III, decreased platelet number, increased D-dimer. The hemostatic tests must be repeated due to rapid changes in the hemostatic mechanism. Beside intensive treatment of the primary disorder causing DIC, we must stop the thrombotic event and substitute the consumed coagulation factors and platelets.
Descriptors		PREGNANCY COMPLICATIONS, HEMATOLOGIC DISSEMINATED INTRAVASCULAR COAGULATION BLOOD COAGULATION TESTS PREGNANCY