ENDOTHELIAL-CELL MARKERS AND FIBRINOPEPTIDE-A TO D-DIMER RATIO AS A MEASURE OF COAGULATION AND FIBRINOLYSIS BALANCE IN NORMAL-PREGNANCY

Objective: Changes in hemostatic system were evaluated in healthy preg nant women. Methods: Blood was sampled in the 1st, 2nd and 3rd trimest ers of gestation, during delivery and 3 days postpartum and plasma fac tors were measured using commercial tests. Results: Thrombin-antithrom bin III complexes, fibrinopeptide A and D-dimer were higher during pre gnancy. The endothelial cell markers, fibronectin and tissue factor, r emained within the normal reference values in the healthy nonpregnant population. This result suggests no endothelial injury and shows no ac tivation of extrinsic coagulation pathway during pregnancy. The balanc e coagulation/fibrinolysy is maintained during pregnancy and delivery, as shown by the ratio fibrinopeptide A/D-dimer, however, a tendency t owards coagulation process is developed in the early puerperium.