Published October 27, 2022 | Version v1
Journal article Open

PLATELET HEMOSTASIS IN THE IMPLEMENTATION OF PLACENTAL DYSFUNCTION

Creators

  • 1. National University of Health of Ukraine named after P.L. Shupyk; KNP «Perinatal Center of Kyiv», Kyiv, Ukraine
  • 2. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
  • 3. Palladin Institute of Biochemistry of NAS of Ukraine, Kyiv, Ukraine

Description

The objective: to study the state of the platelet link of hemostasis in pregnant women with placental dysfunction.
Materials and methods. A clinical and laboratory analysis of 54 patients with placental dysfunction was carried out. The control group included 30 practically healthy women with a physiological course of pregnancy. Venous blood of the patients was collected for testing using vacuum systems in tubes with 3.8% sodium citrate. The functional activity of platelets was studied on a photooptical aggregometer AP2110 (Solar, Belarus), thrombocytogram was performed on a hematological analyzer H18 LIGHT (SFRI SAS, France), thromboelastometric tests were determined on the ROTEM delta system (Tem Innovations GmbH, Germany).
Results. Platelet hemostasis has a significant effect on maximum clot firmness (MCF) according to ROTEM results in patients with placental dysfunction. This indicator can be effective in determination of the hyperreactivity of the platelet unit in patients with placental dysfunction.
Although no statically significant difference was found in the optical aggregometry indicators induced by ADP and collagen between the patients with placental dysfunction and the control group, a clear tendency to a sharp reduction in the lag-period of collagen-induced platelet aggregation in patients with placental dysfunction should be mentioned.
Conclusions. Disorders in the platelet chain of hemostasis can play a significant role in the formation of a thrombophilic state in patients with placental dysfunction, as well as the damage of the endothelium and coagulation changes. The use of a test based on collagen-induced platelet aggregation may be a perspective method for effective diagnosis of platelet hyperreactivity. The study of the platelet link should become an additional element of the laboratory examination in order to resolve the issue of the need to prescribe antiplatelet agents to prevent the development of placental dysfunction.

Files

Platelet hemostasis in the implementation of placental dysfunction.pdf

Files (483.2 kB)

Additional details

References

  • Mykhaloyko OYA. Zminy pokaznykiv trombotsytohramy u patsiyentiv iz perenesenym hostrym ishemichnym insultom zalezhno vid chutlyvosti do terapiyi atsetylsalitsylovoyu kyslotoyu. Bukovynskyy med visnyk. 2020;96(4):75-9.
  • Platonova TN, Zaichko NV, Chernyshenko TM, Gornitskaya OV, Grishchuk VI. Otsenka informativnosti i prognosticheskoy znachimosti traditsionnykh skriningovykh i dopolnitel'nykh laboratornykh testov dlya diagnostiki trombofilii. Laboratorna diagnostika. 2010;4(4):3-10.
  • Volkov GL, Platonova TN, Savchuk AN, Gornitskaya OV, Chernyshenko TM, Krasnobrizhaya YEN. Sovremennyye predstavleniya o sisteme gemostaza. Kiev: Naukova dumka; 2005. 292 s.
  • Us IV, Zhuk SI, Demyanyuk SV. Otsinyuvannya systemy hemostazu u vahitnykh iz platsentarnyu dysfunktsiyeyu metodom rotatsiynoyi tromboelastmetriyi. Reprod zdorovya zhinky. 2022;58(3):6-11.
  • Bates ER, Lau WC. Controversies in antiplatelet therapy for patients with cardiovascular disease. Circulation. 2005;111(17):267-71. doi: 10.1161/01.CIR.0000157158.63751.B2.
  • Bowbrick VA, Mikhailidis DP, Stansby G. Value of thromboelastography in the assessment of platelet function. Clin Appl Thromb Hemost. 2003;9(2):137-42. doi: 10. 1177/1076029603009002.
  • Collins S, Mfcinture C, Hewer I. Thromboelastography: clinical application, interpretation, and transfusion management. AANNA J. 2016;84(2):129-34.
  • Di Benedetto P, Baciarello M, Cabetti L, Martucci M, Chiaschi A, Bestini L. Thrombelastography. Present and future perspective in clinical practice. Minerva Anestesiol. 2003;69(6):501-15.
  • Moser G, Guettler J, Forstner D, Gauster M. Maternal platlets – friend or foe of the human placenta? Int J Mol Sci. 2019;20(22):5639. doi: 10.3390/ijms20225639.
  • Heemskerk JW, Mattheij NJ, Cosemans JM. Platelet-based coagulation: different functions. J Thromb Haemost. 2013;11(1):2-16. doi: 10.1111/jth.12045.
  • Jakobsen C, Larsen JB, FuglsangJ, Hvas AM. Platelet Function in Preeclampsia – a Systematic Review and Meta-Analysis. Platelets. 2019;30(5):549-62. doi: 10.1080/09537104.2019.1595561.
  • Johnson MP, Brennecke SP, East CE, et al. Genetic dissection of the preeclampsia susceptibility locuson chromosçme 2q22 reveals shared novel risk factors for cardiovascular disease. Mol Hum Reprod. 2013;19(7):423-37. doi: 10.1093/molehr/gat011.
  • Kanat-Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil-Koken G, Yilmazer M. Could Mean Platelet Volume in Late First Trimester of Pregnancy Predict Intrauterine Growth Restriction and Pre-Eclampsia? J Obstet Gynaecol Res. 2014;40(7):1840-5. doi: 10.1111/jog.12433.
  • Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013;48(3):452-8. doi: 10.1038/bmt.2012.244.
  • Katz D, Beilin Y. Disoders of coagulation in pregnancy. Br J Anaest. 2015;115(2): ii75-88. doi:10.1093/bja/aev374
  • Reikvam H, Steien E, Hauge B, Liseth K, Hagen KG, Storkson R, et al. Thrombelastography. Transfus Apher Sci. 2009;40(2):119-23. doi: 10.1016/j.transci.2009.01.019.
  • Roberts DE, McNicol A, Bose R. Mechanism of collagen activation in human platelets. J Biol Chem. 2004;279(19):19421-30. doi: 10.1074/jbc.M308864200.
  • Sharmshirsaz AA, Paidas M, Krikun G. Preeclampsia, hypoxia, thrombosis, and inflammation. J Pregnancy. 2012;2012:374047. doi: 10.1155/2012/374047.
  • Song JG, Jeong SM, Jun IG, Lee HM, Hwang GS. Five-minute parameter of thromboelastometry is sufficient to detect thrombocytopenia and hypofibrinogenaemia in patients undergoing liver transplantation. Br J Anaesthesia. 2014;112(2):290-7. doi: 10.1093/bja/aet325.
  • Wardlaw AJ, Moqbel R, Cromwell O, Kay AB. Platelet-activating factor. A potent chemotactic and chemokinetic factor for human eosinophils. J Clin Invest. 1986;78(6):1701-6. doi: 10.1172/JCI112765.
  • Warkentin TE, Aird WC, Rand JH. Platelet-endothelial interactions: sepsis, HIT and antiphospholipid syndrome. Hematol Am Soc Hematol Educ Program. 2003;497-519. doi: 10.1182/asheducation-2003.1.497.
  • Warshaw AL, Laster L, Shulman NR. Protein synthesis by human platelets. J Biol Chem. 1967;242(9):2094-7. doi: 10.1111/j.1538-7836.2008.03211.x
  • Weyrich AS, Scwertz H, Kraiss LW, Zimmerman GA. Protein synthesis by platelets: historical and new perspectives. J Thromb Haemost. 2009;7(2):241-6. doi: 10.1111/j.1538-7836.2008.03211.x.
  • Xie X, Wang M, Lu Y, Zeng J, Wang J, Zhang C, et al. Thromboelastography (TEG) in normal pregnancy and its diagnostic efficacy in patients with gestational hypertension, gestational diabetes mellitus, or preeclampsia. J Clin Lab Anal. 2021;35(2):e23623. doi: 10.1002/jcla.23623.
  • Zaichko NV, Bezsmertnyy YUO, Platonova TM, Chernyshenko TM. Kliniko-laboratorna diahnostyka trombofiliy. Vinnytsya: Metodychni rekomendatsiyi; 2009. 32 s.