Fibrinopeptide a and Intravascular Coagulation in Normotensive and Hypertensive Pregnancy and Parturition

Abstract

Fibrinopeptide A (FpA), fibrin monomers, fibrinogen, fibrin degradation products (FDP) and platelets have been studied during pregnancy, parturition and during toxemia and compared with normal nonpregnant controls in order to evaluate thrombin activity under these conditions. We found a significant rise in fibrinopeptide A levels in late pregnancy and even more so during parturition with a maximum immediately after placental expulsion. We also found elevated FpA levels in toxemic patients, but no significant differences from normal pregnancies. Fibrin monomers were more often elevated during delivery and toxemia than during normal pregnancy. One case report concerning a patient with deficient thrombin activation and heavy postpartum bleeding is added. Our studies indicate an increased thrombin activity and fibrinogen turnover in both normal and toxemic pregnancies. During normal childbirth, coagulation activity seemed to reach a maximum immediately after placental separation.