Skip to main content
SpringerLink
Log in

Hematology and Hemostasis During Pregnancy

  • Chapter
Handbook of Clinical Laboratory Testing During Pregnancy

Part of the book series: Current Clinical Pathology ((CCPATH))

  • 319 Accesses

Abstract

Numerous hematologic and hemostatic changes occur during an uncomplicated pregnancy. Presumably, these alterations have been selected for because they are beneficial to both the mother and the fetus. Plasma expansion in excess of increased red cell production leads to the anemia of pregnancy, and fetal and placental demands tax a mother’s iron and folate stores. Hemostatic changes are associated with an increased risk of maternal morbidity and mortality caused by thrombotic complications, but theoretically may improve maternal and fetal viability by reducing blood loss during parturition. In order to accurately interpret changes in hematologic and hemostatic laboratory measurements when complications arise, it is necessary to first appreciate the physiologic adaptations that occur during normal pregnancies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Koller O, Haram K, Sagen N. Maternal hemoglobin concentration and fetal health. In: Bern MM, Frigoletto FDJ, eds. Hematologic Disorders in Maternal-Fetal Medicine. New York: Wiley-Liss, 1990, pp. 31–46.

    Google Scholar 

  2. Hiss RG. Evaluation of the anemic patient. In: Laros RK, ed. Blood Disorders in Pregnancy. Philadelphia: Lea & Febiger, 1986, pp. 1–18.

    Google Scholar 

  3. Hytten F. Blood volume changes in normal pregnancy. Clin Haematol 1985; 14: 601–612.

    PubMed  CAS  Google Scholar 

  4. Gibson HM. Plasma volume and glomerular filtration rate in pregnancy and their relation to differences in fetal growth. J Obstect Gyneacol Br Commonwealth 1973; 80: 1067–1074.

    Article  CAS  Google Scholar 

  5. Taylor DJ, Lind T. Red cell mass during and after normal pregnancy. Br J Obstet Gynaecol 1979; 86: 364–370.

    Article  PubMed  CAS  Google Scholar 

  6. Cabaniss CD, Cabaniss ML. Physiologic hematology of pregnancy. In: Kitay DZ, ed. Hematologic Problems in Pregnancy. ORadell, N.J.: Medical Economics Books, 1987, pp. 3–14.

    Google Scholar 

  7. Bequin Y, Lipscei G, Thoumsin H, Fillet G. Blunted erythropoietin production and decreased erythropoiesis in early pregnancy. Blood 1991; 78: 89–93.

    Google Scholar 

  8. Bianco I, Mastropietro F, D’Asero C, et al. Serum levels of erythropoietin and soluble transferrin receptor during pregnancy in non-B-thalassemic and B-thalessemic women. Haematologia 2000; 85: 902–907.

    CAS  Google Scholar 

  9. Mercelina-Roumans PE, Ubachs JM, van Wersch JW. The reticulocyte count and its subfractions in smoking and non-smoking pregnant women. Eur J Clin Chem Clin Biochem 1995; 33: 263–265.

    PubMed  CAS  Google Scholar 

  10. Milman N, Graudal N, Nielsen OJ, Agger AO. Serum erythropoietin during normal pregnancy: relationship to hemoglobin and iron status markers and impact of iron supplementation in a longitudinal, placebo-controlled study on 118 women. Int J Hematol 1997; 66: 159–168.

    Article  PubMed  CAS  Google Scholar 

  11. Harstad TW, Mason RA, Cox SM. Serum erythropoietin quantitation in pregnancy using an enzyme-linked immunoassay. Am J Perinatol 1992; 9: 233–235.

    Article  PubMed  CAS  Google Scholar 

  12. Barton PJD, Joy MT, Lappin TR, et al. Maternal erythropoietin in singleton pregnancies: a randomized trial on the effect of oral hematinic supplementation. Am J Obstet Gynecol 1994; 170: 896–901.

    PubMed  CAS  Google Scholar 

  13. Taylor DJ. Pregnancy haemopoiesis. In: Turner T, ed. Perinatal Haematological Problems. Hoboken, NJ, John Wiley & Sons, 1991, pp. 1–22.

    Google Scholar 

  14. Scott DE, Pritchard JA. Iron deficiency in healthy young college women. JAMA 1967; 147: 147–150.

    Google Scholar 

  15. Hallberg L, Hulten L. Iron requirements, iron balance, and iron deficiency in menstruating and pregnant women. In: Halberg L, Asp NG, eds. Iron Nutrition in Health and Disease. London: George Libbey, 1996, pp. 165–182.

    Google Scholar 

  16. Graves BW, Barger MK. A conservative approach to iron supplementation during pregnancy. J Midwifery Womens Health 2001; 46: 159–166.

    Article  PubMed  CAS  Google Scholar 

  17. Puolakka J, Janne O, Jarvinen PA, Vihko R. Serum ferritin as a measure of iron stores during and after normal pregnancy with and without iron supplements. Acta Obstet Gynecol Scand 1980; 95 (suppl): 43–51.

    Article  CAS  Google Scholar 

  18. Johnson TRB, Niebyl JR. Preconception and prenatal care: part of a continuum. In: Gabbe SG, Niebly JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies; London: Churchill Livingstone, 2002, pp. 139–160.

    Google Scholar 

  19. US Preventive Services Task Force. Routine iron supplementation during pregnancy: policy statement and review article. JAMA 1993; 270: 2846–2854.

    Google Scholar 

  20. Gordon MC. Maternal physiology in pregnancy. In: Gabbe SG, Niebly JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. London: Churchill Livingstone, 2002, pp. 63–91.

    Google Scholar 

  21. Milman N, Bergholt T, Byg KE, Eriksen L. Iron status and iron balance during pregnancy: a critical reappraisal of iron supplementation. Acta Anaesthesiol Scand 1999; 78: 749–757.

    CAS  Google Scholar 

  22. Milman N, Byg KE, Agger AO. Hemoglobin and erythrocyte indices during normal pregnancy and postpartum in 206 women with and without iron supplementation. Acta Anaesthesiol Scand 2000; 79: 89–98.

    CAS  Google Scholar 

  23. Taylor DJ, Malien C, McDougall N, Lind T. Effect of iron supplementation on serum ferritin levels during and after pregnancy. Br J Obstet Gynaecol 1982; 89: 1011–1017.

    Article  PubMed  CAS  Google Scholar 

  24. Chanarin I, McFadyen IR, Kyle R. The physiological macrocytosis of pregnancy. Br J Obstet Gynaecol 1977; 84: 504–508.

    Article  PubMed  CAS  Google Scholar 

  25. Nutritional anemias: report of a WHO scientific group. World Health Organization Technical Report Service 1968;405:5–37.

    Google Scholar 

  26. Taylor DJ, Lind T. Haematological changes during normal pregnancy: iron induced macrocytosis. Br J Obstet Gynaecol 1976; 83: 760–767.

    Article  PubMed  CAS  Google Scholar 

  27. Puolakka J. Serum ferritin as a measure of iron stores during pregnancy. Acta Obstet Gynecol Scand 1980; 95 (suppl): 8–31.

    Google Scholar 

  28. Blinder M. Anemia and transfusion therapy. In: Ahya SN, Flood K, Paranjothi S, eds. The Washington Manual of Medical Therapeutics. Lippincott Williams & Wilkins, Philadelphia, PA, 2001, pp. 413–428.

    Google Scholar 

  29. Carriaga MT, Skikne BS, Finley B, Cutler B. Serum transferrin receptor for the detection of iron deficiency in pregnancy. Am J Clin Nutr 1991; 54: 1077–1081.

    PubMed  CAS  Google Scholar 

  30. Akesson A, Bjellerup P, Berglund M, Bremme K. Serum transferrin receptor: a specific marker of iron deficiency in pregnancy. Am J Clin Nutr 1998; 68: 1241–1246.

    PubMed  CAS  Google Scholar 

  31. Choi JY, Pai SH. Change in erythropoiesis with gestational age during pregnancy. Ann Hematol 2001; 80: 26–31.

    Article  PubMed  CAS  Google Scholar 

  32. Frenkel EP, Yardley DA. Clinical and laboratory features and sequelae of deficiency of folic acid and vitamin B12 in pregnancy and gynecology. Hematol Oncol Clin North Am 2000; 14: 1079–1100.

    Article  PubMed  CAS  Google Scholar 

  33. Pryor JA, Morrison JC. Nutritional anemias. In: Bern MM, Frigoletto FD, eds. Hematologic Disorders in Maternal-Fetal Medicine. New York: Wiley-Liss, 1990, pp. 93–1121.

    Google Scholar 

  34. Beisher NA, Mackay EV, Colditz P. Obstetrics and the New Born. London: W. B. Saunders, 1997, pp. 86–89.

    Google Scholar 

  35. Mills JL, McPartin JM, Kirke PN. Homocysteine metabolism in pregnancies complicated by neural tube defects. Lancet 1995; 345: 149–151.

    Article  PubMed  CAS  Google Scholar 

  36. Czeizel AE, Dudas I. Prevention of the first occurrence of neural tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992; 327: 1442–1446.

    Article  Google Scholar 

  37. Rader JI, Yetley EA. Nationwide folate fortification has complex ramifications and requires careful monitoring over time. Arch Intern Med 2002; 162 (letter): 608–609.

    Article  PubMed  Google Scholar 

  38. Pardo J, Peled Y, Bar J, Hod M. Evaluation of low serum vitamin B12 in the non-anaemic pregnant patient. Hum Reprod 2000; 15: 224–226.

    Article  PubMed  CAS  Google Scholar 

  39. Metz J, McGrath K, Bennett M, Hyland K. Biochemical indices of vitamin B12 nutrition in pregnant patients with subnormal serum vitamin B12 levels. Am J Hematol 1995; 48: 251–255.

    Article  PubMed  CAS  Google Scholar 

  40. Kuhnert M, Strohmeier R, Stegmuller M, Halberstadt E. Changes in lymphocyte subsets during normal pregnancy. Eur J Obstet Gynecol Reprod Biol 1998; 76: 147–151.

    Article  PubMed  CAS  Google Scholar 

  41. Sill PR, Lind T, Walker W. Platelet values during normal pregnancy. Br J Obstet Gynaecol 1985; 92: 480–483.

    Article  PubMed  CAS  Google Scholar 

  42. Pitkin RM, Witte DL. Platelet and leukocyte counts in pregnancy. JAMA 1979; 242: 2696–2698.

    Article  PubMed  CAS  Google Scholar 

  43. Delgado I, Reinhard N, Dudenhausen JW. Changes in white blood cells during parturition in mothers and newborn. Gynecol Obstet Investi 1994; 38: 227–235.

    Article  CAS  Google Scholar 

  44. Mercelina-Roumans PE, Ubachs JM, van Wersch JW. Leucocyte count and leucocyte differential in smoking and non-smoking females during pregnancy. Eur J Obstet Gynecol Reprod Biol 1994; 55: 169–173.

    Article  PubMed  CAS  Google Scholar 

  45. Makinoda S, Mikuni M, Furuta I, Okuyama K. Serum concentration of endogenous G-CSF in women during the menstrual cycle and pregnancy. Eur J Clin Invest 1995; 25: 877–879.

    Article  PubMed  CAS  Google Scholar 

  46. Tsakonas DP, Nicolaides KH, Tsakona CP, Worman CP. Changes in maternal plasma macrophage-colony stimulating factor levels during normal pregnancy. Clin Lab Haemat 1995; 17: 57–59.

    Article  CAS  Google Scholar 

  47. Tygart SG, McRoyan DK, Spinnato JA, McRoyan CJ. Longitudinal study of platelet indices during normal pregnancy. Am J Obstet Gynecol 1986; 154: 883–887.

    PubMed  CAS  Google Scholar 

  48. Fenton V, Saunders K, Cavill I. The platelet count in pregnancy. J Clin Path 1977; 30: 68–69.

    Article  PubMed  CAS  Google Scholar 

  49. Fay RA, Hughes AO, Farron NT. Platelets in pregnancy: hyperdestruction in pregnancy. Obstet Gynecol 1983; 61: 238–240.

    PubMed  CAS  Google Scholar 

  50. Verdy E, Bessous V, Dreyfus M, Kaplan C, Tchernia G, Uzan S. Longitudinal analysis of platelet count and volume in normal pregnancy. Thromb Haemost 1997; 77: 806–807.

    PubMed  CAS  Google Scholar 

  51. O’Brian JR. Platelet counts in normal pregnancy. J Clin Path 1976; 29: 174.

    Article  Google Scholar 

  52. Wallenburg HC, Van Kessel PH. Platelet lifespan in normal pregnancy as determined by a nonradioisotopic technique. Br J Obstet Gynaecol 1978; 85: 33–36.

    Article  PubMed  CAS  Google Scholar 

  53. Rinder HM, Bonan JL, Anandan S, Rinder CS. Noninvasive measurement of platelet kinetics in normal and hypertensive pregnancies. Am J Obstet Gynecol 1994; 170: 117–122.

    PubMed  CAS  Google Scholar 

  54. Mercelina-Roumans PE, Ubachs JM, van Wersch JW. Platelet count and platelet indices at various stages of normal pregnancy in smoking and non-smoking women. Eur J Clin Chem Clin Biochem 1995; 33: 267–269.

    PubMed  CAS  Google Scholar 

  55. Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol 2000; 95: 29–33.

    Article  PubMed  CAS  Google Scholar 

  56. Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med 1993; 329: 1463–1466.

    Article  PubMed  CAS  Google Scholar 

  57. Saino S, Kekomaki R, Riikonen S, Teramo K. Maternal thrombocytopenia at term: a population-based study. Acta Obstet Gynecol Scand 2000; 79: 744–749.

    Article  Google Scholar 

  58. Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Sem Hematol 2000; 37: 275–289.

    Article  CAS  Google Scholar 

  59. Tefferi A, Silverstein MN, Petitt RM, Hoagland HC. Outcome analysis of 34 pregnancies in women with essential thrombocythemia. Arch Intern Med 1995; 155: 1217–1222.

    Article  PubMed  Google Scholar 

  60. Vantroyen B, Vanstraelen D. Management of essential thrombocythemia during pregnancy with aspirin, interferon alpha-2a and no treatment: a comparative analysis of the literature. Acta Haematol. 2002; 107: 158–169.

    Article  PubMed  CAS  Google Scholar 

  61. Aune B, Gjesdal K, Oian P. Late onset postpartum thrombocytosis in preeclampsia. Acta Anaesthesiol Scand 1 999; 78: 866–870.

    Google Scholar 

  62. Atalla RK, Thompson JR, Oppenheimer CA. Reactive thrombocytosis after ceasarean section and vaginal delivery: implications for maternal thromboembolism and its prevention. Br J Obstet Gynaecol 2000; 107: 411–414.

    Article  CAS  Google Scholar 

  63. Hathaway WE, Bonnar J. Hemostatic disorders of the pregnant woman and newborn infant. New York: Elsevier, 1987, pp. 39–56.

    Google Scholar 

  64. Lindqvist PG, Svensson PF, Dahback B, Marsal K. Factor V Q506 mutation (activated protein C resistance), associated with reduced intrapartum blood loss: a possible evolutionary selection mechanism. Thromb Haemost 1998; 79: 69–73.

    PubMed  CAS  Google Scholar 

  65. de Swiet M. Maternal mortality: confidential enquiries into maternal deaths in the United Kingdom. Am J Obstet Gynecol 2000; 182: 760–766.

    Article  PubMed  Google Scholar 

  66. Rutherford S, Montoro M, McGhee W, Strong T. Thromboembolic disease associated with pregnancy: an 11 year review. Am J Obstet Gynecol 1991;164(suppl).

    Google Scholar 

  67. McColl MD, Ramsay JE, Tait RC, et al. Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 1997; 78: 1183–1188.

    PubMed  CAS  Google Scholar 

  68. Ginsberg JS, Brill-Edwards P, Burrows RF. DVT during pregnancy: leg and trimester of presentation. Thromb Haemost 1992; 67: 519–520.

    PubMed  CAS  Google Scholar 

  69. Lanska DJ, Kryscio RJ. Risk factors for peripartum and postpartum stroke and intracranial venous thrombosis. Stroke 2000; 31: 1274–1282.

    Article  PubMed  CAS  Google Scholar 

  70. Roth A, Elkayam U. Acute myocardial infarction associated with pregnancy. Ann Intern Med 1996; 125: 751–762.

    PubMed  CAS  Google Scholar 

  71. Rosenberg RD, Aird WC. Vascular-bed specific hemostasis and hypercoaguable states. N Engl J Med 1999; 340: 1555–1564.

    Article  PubMed  CAS  Google Scholar 

  72. Sharma SK, Philip J, Whitten CW. Thromboelastography in preeclamptic patients. Reg Anesth Pain Med 1996; 21: 493–495.

    CAS  Google Scholar 

  73. Kjellberg U, Hellgren M. Sonoclot signature during normal pregnancy. Intensive Care Med 2000; 26: 206–211.

    Article  PubMed  CAS  Google Scholar 

  74. Steer PL, Krantz HB. Thromboelastography and sonoclot analysis in the healthy parturients. J Clin Anesth 1993; 5: 419–424.

    Article  PubMed  CAS  Google Scholar 

  75. Kundu SK, Heilmann EJ, Sio R, Garcia C, Davidson RM, Ostgaard RA. Description of an in vitro platelt function analyzer: PFA-100. Sem Thromb Hemost 1995; 21 (suppl 2): 106–112.

    Google Scholar 

  76. Kjellberg U, Andersson NE, Rosen S, Tengborn L, Hellgren M. APC resistance and other haemostatic variables during pregnancy and puerperium. Thromb Haemost 1999; 81: 527–531.

    PubMed  CAS  Google Scholar 

  77. Beller FK, Ebert C. The coagulation and fibrinolytic enzyme system in pregnancy and in the puerperium. Eur J Obstet Gynecol Reprod Bio 1982; 13: 177–197.

    Article  CAS  Google Scholar 

  78. Reid DE, Frigoletto FD, Tullis JL, Hinman J. Hypercoagulable states in pregnancy. Am J Obst Gynecol 1971; 111: 493–504.

    CAS  Google Scholar 

  79. Vincelot A, Nathan N, Collet D, Mehaddi Y, Grandchamp P, Julia A. Platelet function during pregnancy: an evaluation using the PFA-100 analyser. Br J Anaesth 2001; 87: 890–893.

    Article  PubMed  CAS  Google Scholar 

  80. Whigham KAE, Howie PW, Drummond AH, Prentice CRM. Abnormal platelet function in preeclampsia. Br J Obstet Gynaecol 1978; 85: 28–32.

    Article  PubMed  CAS  Google Scholar 

  81. O’Brien WF, Saba HI, Knuppel RA, Scerbo JC, Cohen GR. Alterations in platelet concentration and aggregation in normal pregnancy and preeclampsia. Am J Obstet Gynecol 1986; 155: 486–490.

    PubMed  Google Scholar 

  82. Norris LA, Sheppard BL, Bonnar J. Increased whole blood platelet aggregation in normal pregnancy can be prevented in vitro by aspirin and dazmegrel. Br J Obstet Gynaecol 1992; 99: 253–257.

    Article  PubMed  CAS  Google Scholar 

  83. Lewis PJ, Boylan P, Friedman LA, Hensbey CN, Downing I. Prostacyclin in pregnancy. Br Med J 1980; 282: 1581–1582.

    Article  Google Scholar 

  84. Frigoletto FD, Tullis JL, Reid DE, Hinman J. Hypercoagulability in the dysmature syndrome. Am J Obstet Gynecol 1971; 111: 867–873.

    PubMed  CAS  Google Scholar 

  85. Stirling Y, Woolf L, Norht WRS, Seghatchian MJ, Meade TW. Haemostasis in normal pregnancy. Thromb Haemost 1984; 52: 176–182.

    PubMed  CAS  Google Scholar 

  86. Hellgren M, Blomback M. Studies on blood coagulation and fibrinolysis in pregnancy, during delivery, and in the puerperium. Gynecol & Obstetric Investigation. 1981; 12: 141–154.

    Article  CAS  Google Scholar 

  87. Clark P, Brennand J, Conkie JA, McCall F, Greer IA, Walker ID. Activated protein C sensitivity, protein C, protein S and coagulation in normal pregnancy. Thromb Haemost 1998; 79: 1166–1170.

    PubMed  CAS  Google Scholar 

  88. Faught W, Garner P, Jones G, Ivey B. Changes in protein C and protein S levels in normal pregnancy. Am J Obstet Gynecol 1995; 172: 147–150.

    Article  PubMed  CAS  Google Scholar 

  89. Suzuki S, Sakamoto W. The kinetics of blood coagulability: fibrinolytic and kallikrein-kinin system at the onset and during labor. Eur J Obstet Gynecol Reprod Biol 1984; 17: 209–218.

    Article  PubMed  CAS  Google Scholar 

  90. Comp PC, Thurnas GR, Welsh J, Esmon CT. Functional and immunolgic protein S levels are decreased during pregnancy. Blood 1986; 68: 881–885.

    PubMed  CAS  Google Scholar 

  91. Bombeli T, Raddatz-Mueller P, Fehr J. Coagulation activation markers do not correlate with the clinical risk of thrombosis in pregnant women. Am J Obstet Gynecol 2001; 184: 382–389.

    Article  PubMed  CAS  Google Scholar 

  92. Eichinger S, Weltermann A, Philipp K, et al. Prospective evaluation of hemostatic system and thrombin potential in healthy pregnant women with and without factor V Leiden. Thromb Haemost 1999; 82: 1232–1236.

    PubMed  CAS  Google Scholar 

  93. Kluft C, Lansink M. Effect of oral contraceptives on haemostasis variables. Thromb Haemost 1997; 78: 315–326.

    PubMed  CAS  Google Scholar 

  94. Vanderbroucke JP, Koster T, Briet E, Reitsman PH, Bertina RM, Rosendaal FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet 1994; 344: 1453–1457.

    Article  Google Scholar 

  95. van Hylckama A, van der Linden IK, Bertina RM, Rosendaal FR. High levels of factor IX increase the risk of venous thrombosis. Blood 2000; 95: 3678–3682.

    Google Scholar 

  96. van der Meer FJM, Koster T, Vanderbroucke JP, Briet E, Rosendaal FR. The Leiden Thrombophilia Study (LETS). Thromb Haemost 1997; 78: 631–635.

    PubMed  Google Scholar 

  97. Kruithof EKO, Tran-Thang C, Gudinchet AH, et al. Fibrinolysis in pregnancy: a study of plasminogen activator inhibitors. Blood 1987; 69: 460–466.

    PubMed  CAS  Google Scholar 

  98. Bonnar J, Daley L, Sheppard B. Changes in the fibrinolytic system during pregnancy. Sem Thromb Hemost 1990; 16: 221–229.

    Article  CAS  Google Scholar 

  99. Wright JG, Cooper P, Astedt B, et al. Fibrinolysis during normal human pregnancy: complex interrelationships between plasma levels of tissue plasminogen activator and inhibitors and the euglobulin lysis clot lysis time. Br J Haematol 1988; 69: 253–258.

    Article  PubMed  CAS  Google Scholar 

  100. Arias F, Andrinopoulos G, Zamora J. Whole blood fibrinolytic activity in normal and hypertensive pregnancies and its relation to the placental concentration of urokinase inhibitor. Am J Obstet Gynecol 1979; 133: 624–629.

    PubMed  CAS  Google Scholar 

  101. Chabloz P, Reber G, Boehlen F, Hohfeld P, de Moerloose P. TAFI antigen and D-dimer levels during normal pregnancy and at delivery. Br J Haematol 2001; 115: 150–152.

    Article  PubMed  CAS  Google Scholar 

  102. Williams E. Disseminated intravascular coagulation. In: Loscalzo J, Schafer AI, eds. Thrombosis and Hemorrhage. Baltimore: Williams & Wilkins, 1998, pp. 963–985.

    Google Scholar 

  103. Oshiro BT, Branch DW. Maternal hemostasis: coagulation problems of pregnancy. In: Loscalzo J, Schafer AI, eds. Thrombosis and Hemorrhage. Baltimore: Williams & Wilkins, 1998, pp. 1005–1026.

    Google Scholar 

  104. Sadler JE. Biochemistry and genetics of von Willebrand factor. Annu Rev Biochem 1998; 67: 395–424.

    Article  PubMed  CAS  Google Scholar 

  105. Nichols WC, Cooney KA, Ginsberg D, Ruggeri ZM. von Willebrand disease. In: Loscalzo J, Schafer AI, eds. Thrombosis and Hemorrhage. Baltimore: Williams & Wilkins, 1998, pp. 729–755.

    Google Scholar 

  106. Greer IA. Thrombosis in pregnancy: maternal and fetal issues. Lancet 1999; 353: 1258–1265.

    Article  PubMed  CAS  Google Scholar 

  107. Greer IA, Lowe GDO, Walker JJ, Forbes CD. Haemorrhagic problems in obstetrics and gynaecology in patients with congenital coagulopathies. Br J Obstet Gynaecol 1991; 98: 909–918.

    Article  PubMed  CAS  Google Scholar 

  108. Ridker PM, Miletich JP, Hennekens CH, Buring JE. Ethnic distribution of factor V Leiden in 4047 men and women: implications for venous thromboembolism screening. JAMA 1997; 277: 1305–1307.

    Article  PubMed  CAS  Google Scholar 

  109. Bertina RM, Koelman PC, Koster T, Rosendaal FR. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994; 369: 64–67.

    Article  PubMed  CAS  Google Scholar 

  110. Bokarewa MI, Bremme K, Blomback M. Arg 506-Gln mutation in factor V and risk of thrombosis during pregnancy. Br J Haematol 1996; 92: 473–478.

    Article  PubMed  CAS  Google Scholar 

  111. Martineli IM, De Stevano V, Taioli E, Paciaroni K, Rossi E, Mannucci PM. Inherited thrombophilia and first venous thromboembolism during pregnancy and puerperium. Thromb Haemost 2002; 87: 791–795.

    Google Scholar 

  112. Gerhardt A, Scharf RE, Beckmann MW, et al. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Engl J Med 2000; 342: 374–380.

    Article  PubMed  CAS  Google Scholar 

  113. Poort SR, Rosendaal FR, Koelman PC, Koster T. A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996; 88: 3698–3703.

    PubMed  CAS  Google Scholar 

  114. McColl MD, Reid DE, Tait RC, Walker ID, Greer IA. Prothrombin G20210A, MTHFR C677T mutations in women with venous thromboembolism associated with prengnancy. Br J Obstet Gynaecol 2000; 107: 565–569.

    Article  CAS  Google Scholar 

  115. Ray JG, Shmorgun D, Chan WS. Common C6778T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of venous thromboembolism: meta-analysis of 31 studies. Pathophysiol Haemost Thromb 2002; 32: 51–58.

    Article  PubMed  CAS  Google Scholar 

  116. Kelly PJ, Rosand J, Kistler JP, Shih VE, Silveira S. Homocysteine, MTHFR C677T polymorphism and risk of ischemic strokes: results of a meta-analysis. Neurology 2002; 59: 529–536.

    Article  PubMed  CAS  Google Scholar 

  117. Ginsberg JS, Greer IA, Hirsh J. Use of antithrombotic agents during pregnancy. Chest 2001; 119(suppl):122S-131 S.

    Google Scholar 

  118. Alfirevic Z, Roberts D, Martlew V. How strong is the association between maternal throbophilia and adverse pregnancy outcome? a systematic review. Eur J Obstet Gynecol 2002; 101: 6–14.

    Article  Google Scholar 

  119. Meinardi JR, Middeldorp S, de Kam P, et al. Increased risk for fetal loss in carriers of the factor V Leiden mutation. Ann Intern Med 1999; 130: 736–739.

    PubMed  CAS  Google Scholar 

  120. Rey E, Kahn SR, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 2003; 361: 901–908.

    Article  PubMed  Google Scholar 

  121. McCowan LME, Craigie S, Taylor RS, Ward C, McLintock C, North RA. Inherited thrombophilias are not increased in “idiopathic” small-for-gestational-age pregnancies. Am J Obstet Gynecol 2003; 188: 981–985.

    Article  PubMed  Google Scholar 

  122. Infante-Reivard C, Rivard G, Yotov WV, Genin E, Gurigeut M, Weinbert C. Absence of association of thrombophilia polymorphisms with intrauterine growth restriction. N Engl J Med 2002; 347: 19–25.

    Article  Google Scholar 

  123. Verspyck E, Le Cam-Duchez V, Goffinet F, Tron F, Marpeau L, Borg JY. Thrombophilia and immunological disorders in pregnancies as risk factors for small for gestational age infants. Br J Obstet Gynaecol 2002; 109: 28–33.

    Article  Google Scholar 

  124. Morrison ER, Meidzbrodzka H, Campbell DM, et al. Prothrombotic genotypes are not associated with pre-eclampsia and gestational hypertension: results from a large population-based study and systematic review. Thromb Haemost 2002; 87: 779–785.

    PubMed  CAS  Google Scholar 

  125. Benedetto CM, Salton L, Maula V, Chieppa G, Massobrio M. Factor V Leiden and factor II G20210A in preeclampsia and HELLP syndrome. Acta Obstet Gynecol Scand 2002; 81: 1095–1100.

    Article  PubMed  Google Scholar 

  126. Meeks GR, Gookin K, Morrison JC. Iron deficiency anemia in pregnancy. In: Kitay DZ, ed. Hematologic Problems in Pregnancy. Oradell, NJ: Medical Economics Books, 1987.

    Google Scholar 

  127. van Wersch JW, Ubachs JM. Blood coagulation and fibrinolysis during normal pregnancy. Eur J Clin Chem Clin Biochem 1991; 29: 45–50.

    PubMed  Google Scholar 

Download references

Authors
  1. Charles S. Eby MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Departments of Pathology and Immunology and Obstetrics and Gynecology, Washington University School of Medicine, and Clinical Chemistry and Serology Laboratories, Barnes-Jewish Hospital, St. Louis, MO, USA

    Ann M. Gronowski PhD, DABCC

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Humana Press, Totowa, NJ

About this chapter

Cite this chapter

Eby, C.S. (2004). Hematology and Hemostasis During Pregnancy. In: Gronowski, A.M. (eds) Handbook of Clinical Laboratory Testing During Pregnancy. Current Clinical Pathology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-787-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-787-1_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9862-2

  • Online ISBN: 978-1-59259-787-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation