SOLUBLE FIBRIN IN PLASMA AS A SIGN OF ACTIVATED COAGULATION IN PATIENTS WITH PREGNANCY COMPLICATIONS

Background. Disseminated intravascular coagulation (DIG) is a frequent ly observed complication in pregnant women. The laboratory diagnosis o f DIC is difficult but the development in the detection of circulating soluble fibrin has improved the possibility. Methods. A number of pre gnant women (n=175) with obstetric complications e.g. preeclampsia, hy pertension, intrauterine growth retardation (IUGR) and intrahepatic ch olestasis was examined for plasma soluble fibrin and subjected to some routine hemostatic tests, mainly during the third trimester of pregna ncy. Results. Of these patients, 57 of 175 (33%) had an elevated conce ntration of soluble fibrin (above 23 nmol/L) as compared with a health y group of women sampled in the third trimester. Eighteen patients (10 %) had highly increased levels, above 100 nmol/L. In comparison, none of the 23 healthy, pregnant women investigated had a value above 40 nm ol/L. Conclusions. Hemostatic abnormalities, including increased conce ntrations of soluble fibrin, are quite frequently observed in women wi th obstetric complications, most likely as a sign of a systemic activa tion of coagulation. Although a higher concentration of plasma soluble fibrin was observed in many of the women, no clear correlation to the outcome of the pregnancy was obtained. Whether or not plasma soluble fibrin is of any value, either diagnostically or the treatment of pati ents with pregnancy complications, remains to be shown.