|Monitoring of Hemostatic Parameters for Early Prediction of First-trimester Miscarriage.|
Jiang L, Du Y, Lu Y, Wu X, Tong X.
Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals. 2021; (): 1-17
BACKGROUND: Hypercoagulation starts as early as the first-trimester pregnancy and is a risk factor for thromboembolic events which are associated with miscarriage. Our study aimed to investigate coagulation, platelets, and fibrinolysis parameters alteration among trimester-specific normal pregnancy and first-trimester miscarriage patients. We also test the accuracy of hemostatic parameters determination for prediction of first-trimester miscarriage. METHODS: Retrospective investigation of 50 women whose most recent pregnancy had ended in the first trimester and 54 age-matched consecutive normal pregnancy between 2016-2019. Furthermore, 51 non-pregnant, age-matched women were included in parallel to healthy controls. 12 Screening tests for coagulation and platelet parameters were assessed. RESULTS: We found plasma levels of aPTT, FBG, TT were significantly prolonged or decreased in miscarriage subjects than the corresponding first phase in normal pregnancies. PT, INR, aPTT and D-dimer all shift back to normal in miscarriage patients compared with non-pregnant women. Shortened aPTT combined with TT and FBG can predicted the occurrence of first-trimester miscarriage with an AUC of 0.831. CONCLUSIONS: Routine assessment of aPTT combined with TT and FBG is a low-cost, widely available marker for prediction of first-trimester miscarriage.