UDC

612.115.12:618.2

Authors

Pavlovskaya Yuliya Mikhailovna, Postgraduate Student, Northern State Medical University (Arkhangelsk, Russia) 

Abstract

Normally developing pregnancy is accompanied by a number of most important biochemical, neuroendocrine and morphological changes in a woman’s body, which create conditions for the functioning of the “mother–placenta–fetus” system. It is well-known that hemostasis plays an important role in maintaining the physiology of the fetoplacental system. In the course of physiological pregnancy, the activity and level of coagulation factors undergo certain changes. Their activity changes in various ways, but the result of these changes is increased blood coagulation potential. For example, fibrinogen level starts increasing in the 3rd month of pregnancy and reaches its maximum at childbirth. Fibrinogen is the main substrate of blood clotting required to ensure adequate hemostasis after delivery of placenta. At the same time, by the end of the 3rd trimester the activity of factor XIII is reduced by 40–50 %. Both of these factors play an important role in the processes of implantation and placentation. Decreased or increased levels of fibrinogen and factor XIII, compared to normal values, can lead to placental insufficiency, fetal hypoxia, delayed growth and development or fetal death. Placenta itself, in its turn, is a regulator of mother’s hemostasis: both procoagulant and anticoagulant factors are formed in it. During the postpartum period, the concentration and activity of coagulation factors gradually reach the normal levels. Changes in the pregnant woman’s hemostatic system are a physiological adaptation of the body caused by the formation of utero-placental circulation. The knowledge of adaptive changes of the hemostatic system at physiological pregnancy allows us to make more accurate diagnoses of blood coagulation disorders in obstetrics.

Keywords

pregnancy, fibrinogen, blood coagulation factor XIII, placenta.

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