The features of secretory activity of platelets and fibrinolysis in women with various types of hypertensive disorders in the third trimester of pregnancy: 618.3-06:616.12-008.331.1:616.151.5

Abstract

Summary. Background. Hypertensive disturbances during pregnancy are jointly with the adaptive disorders of both blood coagulation and fibrinolysis, and platelets and endothelium plays important role for that. The disorders severity of platelet hemostasis and fibrinolysis is various in pregnant women with hypertensive disturbances. Objectives: to study the platelets secretory activity and some fibrinolytic components in women with hypertensive disturbances of various genesis in the III trimester of pregnancy. Patients/Methods. We examined 238 women in the III trimester of pregnancy: 70 normotensive women, 32 with moderate preeclampsia (PE), 47 with severe PE, 58 with chronic arterial hypertension (AH), and 30 with PE joint with chronic AH. The lab testing included the number and average concentration of platelet components, platelet-induced secretion of ATP, the β-thromboglobulin and platelet factor 4 in blood plasma. Fibrinolytic system was tested with determining of clot lysis level, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) in plasma. Results. Obtained data showed different severity of hemostasis disturbances in hypertensive disturbances of various genesis. In moderate and severe PE increased levels of t-PA and PAI-1 were revealed; in addition, in severe PE, decreased platelets number and ATP secretion by activated platelets was detected with increasing of their granulocyticity. In PE with chronic AH, decreased ATP secretion by activated platelets with increasing of their granulocyticity and basal secretion of beta-thromboglobulin was found, also increased t-PA and PAI-1 plasma content was determined. Increased platelet count was detected in chronic AH. Conclusions. Revealed changes led to the conclusion about the heterogeneity of hemostasis changes in pregnant women with various forms of hypertensive disturbances in the III trimester of pregnancy.

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