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Abstract：
Background During pregnancy, a physiological increase of molecular activation markers (MAM) of hemostasis such as prothrombin fragments 1 + 2, thrombin-antithrombin complex, and D-dimers (DD) occurs. Therefore, monitoring MAM levels during pregnancy to evaluate the risk of venous thromboembolism (VTE) may be unreliable; nevertheless, DD analysis in pregnancy is widely performed. In contrast to DD, fibrin monomer (FM) levels have been reported to remain stable during pregnancy. Objectives The main aim of this study was to define the expected range for FM levels in pregnant outpatients. In addition, we examined the impact of the individual VTE risk, as calculated by the pregnancy risk score of the Royal College of Obstetricians and Gynaecologists (RCOG), as well as that of antithrombotic treatment on FM levels. Methods A total of 342 pregnant women seen at our hemostasis unit were included throughout 350 pregnancies in 899 samples. Results Low-risk thrombophilia, but not the RCOG score itself, was found to influence all MAM levels, whereas antithrombotic treatment had only an impact on DD. For FM, a reference range could be calculated irrespective of the pregnancy term, in contrast to other MAMs, which fluctuated throughout pregnancy. Conclusions Our findings suggest a stronger impact of inherited thrombophilia on hemostasis activity during pregnancy as compared with acquired or other predisposing thrombophilic risk factors. FM levels showed a marginal increase during pregnancy in contrast to other MAM and remain a potential candidate to improve the laboratory assessment of VTE risk during pregnancy. Further prospective studies in pregnant patients with suspicion of VTE are needed.
摘要：
怀孕期间的背景，生理增加的分子激活标记（MAM）的止血，如凝血酶原片段1+2，凝血酶-抗凝血酶复合物，和D-二聚体(DD)发生。因此,在妊娠期监测MAM水平以评估静脉血栓栓塞（VTE）的风险可能是不可靠的;然而，妊娠中的DD分析广泛进行。与DD相比，据报道，纤维蛋白单体（FM）水平在怀孕期间保持稳定。目的本研究的主要目的是确定妊娠门诊患者FM水平的预期范围。此外,我们检查了个体VTE风险的影响，根据皇家妇产科学院（RCOG）的妊娠风险评分计算，以及FM水平的抗血栓治疗。方法在我们的止血单元中，共有342名孕妇被纳入899个样本中的350例妊娠。结果低风险血栓形成倾向，但不是RCOG分数本身，被发现影响所有MAM水平，而抗血栓治疗仅对DD有影响.对于FM，可以计算参考范围，而不考虑妊娠期限，与其他MAM相比，在整个怀孕期间波动。结论我们的发现表明，与获得性或其他易感的易栓性危险因素相比，遗传性易栓性对妊娠期间止血活动的影响更大。与其他MAM相比，FM水平在怀孕期间显示出轻微的增加，并且仍然是改善怀孕期间VTE风险的实验室评估的潜在候选者。需要对怀疑VTE的妊娠患者进行进一步的前瞻性研究。
