fibrinopeptide-a and Placental-Insufficiency

To examine the hypothesis that Doppler-defined umbilical placental insufficiency is associated with intravascular coagulation in the fetal circulation.. A prospective, descriptive, single centre study.. The University of Sydney, Department of Obstetrics at Westmead Hospital.. Ninety-one infants were classified on the basis of the systolic:diastolic (SD) ratio of the umbilical artery flow velocity waveforms into severe (SD > 99.9th centile), moderate (SD > 95th centile) or control groups.. Blood was collected from the umbilical vein at delivery.. The coagulation variables measured were the plasma concentrations of thrombin-antithrombin, fibrinopeptide A and fibrinogen, the antithrombin III activity, the prothrombin time and the activated partial thromboplastin time.. There were no differences in activated partial thromboplastin time, antithrombin III activity, fibrinopeptide A or thrombin-antithrombin complex concentrations between fetuses with placental insufficiency and those with no placental disease. Fetuses with severe and moderate placental insufficiency had a statistically significant prolongation of their mean prothrombin time compared to controls (23.7 +/- 0.8, 23.6 +/- 1.6, and 19.9 +/- 0.6 s, respectively). Infants in the severe group had a lower plasma fibrinogen concentration than control fetuses (1.66 +/- 0.09 and 1.94 +/- 0.09 g/l, respectively). The activated partial thromboplastin time and antithrombin III activity were both highly dependent on gestational age.. These results do not support the hypothesis that Doppler-defined umbilical placental insufficiency is associated with activation of coagulation in the fetal circulation.

Topics: Antithrombin III; Blood Coagulation; Female; Fetal Blood; Fibrinogen; Fibrinopeptide A; Gestational Age; Humans; Infant, Newborn; Partial Thromboplastin Time; Placental Insufficiency; Pregnancy; Prospective Studies; Prothrombin Time; Ultrasonography, Prenatal