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Microvesicles, Fibrinolytic and Coagulation Biomarkers in Blood from Pregnant Women

1Nîmes University Hospital, Department of Haematology, Nimes, France, 2Montpellier University, Research Laboratory EA 2992, Montpellier, France, 3Faculty of Pharmaceutical and Biological Sciences, Montpellier University, Department of Haematology, Montpellier, France, 4Aix-Marseille Université, C2VN, UMR-1263, INSERM, INRA 1260, UFR de Pharmacie, Marseille, France, 5CHU La Conception, APHM, Department of Hematology and Vascular Biology, Marseille, France, 6Nîmes University Hospital, Department of Gynecology and Obstetrics, Nimes, France, 7Max Mousseron Institute of Biomolecules, CNRS UMR 5247, Montpellier University, Department of Artificial Polymers, Montpellier, France, 8Nîmes University Hospital, Department of Biostatistics, Public Health and Innovation in Methodology, Nimes, France, 9BioCytex, Research and Technology Department, Marseille, France

Abstract Number: PB2515

Meeting: ISTH 2020 Congress

Theme: Women Health » Pregnancy and Pregnancy Complications

Background: Multiple changes in the haemostatic system occur during pregnancy. The increase in the concentration of coagulation factors characterizes pregnancy as a hypercoagulable state, fuelling an increase in D-dimers, which suggests that fibrinolysis remains an active process. Recently, increased attention has also been paid to the relationship between circulating microvesicles and hypercoagulability in normal and complicated pregnancies.

Aims: The aim of our pilot study was to monitor procoagulant- and fibrinolytic-related parameters during pregnancy; namely D-dimers (DDI), fibrin monomers (FM) and pro-coagulant/pro-fibrinolytic microvesicles (MV).

Methods: DDI, FM and MV were assayed using two commercially available techniques for DDI and FM (Vidas D-dimer Exclusion™, Biomérieux, and STA®-Liatest® FM, Stago, France, respectively) and functional procoagulant and fibrinolytic activities for MV. Quantifications were performed from 50 normal pregnancies and 35 placenta-mediated counterpart complications (clinicaltrials.gov identifier: NCT01736826). Among the 50 normal pregnant women, 17 were randomly sampled for testing every 4 weeks for 6 months from the 3rd month of pregnancy to delivery.

Results: Kinetics of DDI, FM and MV showed that DDI and pro-fibrinolytic microvesicles increased over time during pregnancy (p< 0.001 for both), whereas there was no significant variation in FM or pro-coagulant MV (p=0.128 and p=0.202 respectively). However, the global aspect of the distribution of the FM and procoagulant microvesicles levels was not monotonous throughout pregnancy with higher values before delivery. Moreover, women with complicated pregnancies had a clear tendency towards increased DDI, FM, pro-coagulant and pro-fibrinolytic MV values overlapping those found in normal pregnancies, indicating a significant biological behavioral heterogeneity within the population termed “placenta-mediated complications”.

Conclusions: Our work shows that fibrinolytic activity is maintained throughout pregnancy suggesting that it may be essential for the progress of pregnancy. It also suggests a biological heterogeneity in women with placenta-mediated complications, which deserves further investigation.

To cite this abstract in AMA style:

Bouvier S, Lacroix R, Letouzey V, Demattei C, Fortier M, Judicone C, Nouvellon E, Mercier E, Mousty E, Dignat-George F, Gris J-. Microvesicles, Fibrinolytic and Coagulation Biomarkers in Blood from Pregnant Women [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/microvesicles-fibrinolytic-and-coagulation-biomarkers-in-blood-from-pregnant-women/. Accessed November 29, 2023.

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