Coagulation and fibrinolysis in viable mid-trimester pregnancies of normal, intrauterine growth retardation, chromosomal anomalies and hydrops fetalis and their eventual obstetric outcome

A total of 71 pregnant women diagnosed by ultrasound to have viable fetus i n late mid- trimester pregnancies of normal, IUGR, hydrops fetalis and chro mosomal anomalies were studied for their coagulation, fibrinolytic and inhi bitor levels with association on eventual obstetrics outcome. A hypercoagul able state was observed in all the pregnancies studied. However, higher hyp ercoagulation evidenced by significantly raised prothrombin formation and c lot elasticity together with higher levels of D-dimer, uPA antigen and PAI- 1 than observed in normal pregnancy suggests a hyperfibrinolytic/inhibitor state in hydrops fetalis pregnancy associated with bad obstetric outcome. I n IUGR pregnancy associated with good outcome further enhanced clot elastic ity was seen whilst no significant differences were observed in pregnancy w ith chromosomal anomalies when compared to uncomplicated normal pregnancy. Our study suggests that in hydrops fetalis pregnancy, further enhanced prot hrombin formation and hyperfibrinolysis/inhibitor at late mid- trimester is associated with a poor obstetric outcome.