Background: The pregnancy of women with kidney disease is followed by increased frequency of gestational complications development such as endotheliosis, inflammation, oxidative stress, and hemostatic impairments. In this connection, a particular relevance is the search for objective and informative criteria for blood clotting disorders in pregnant women.

Aims: The aim – to make easier the forecasting of possible complications in mother and a child, evaluation of their condition severity, and therapy efficacy.

Methods: A group of 48 women with physiologic course of pregnancy was observed (mean age 27.3±4.1 years) as well as a group of 44 pregnant women with chronic kidney disease (CKD) (mean age 29.1±3.6 years) in the third trimester of gestation. Investigations were carried out using laboratory diagnostic test “Thrombodynamic register T-2” which allowed to characterize the process of spatio-temporal blood clot formation at a new level. In parallel, In parallel, routine hemostasis assessment tests were used.

Results: It was established, that in a majority of female patients (88.9%) with СКD, some indicators were decreased (APTT by 14.8%, and INA by 21.7%) but fibrinogen concentration in blood increased by 15.8%, i.e. there were hypercoagulable changes. The thrombodynamic data showed that the speed of fibrin clot growth increased by 31.7%; initial speed of clot growth increased by 17.5%, and stationary speed of clot growth increased by 9.5%, and the size of clot grew by 15.9% as compared with indicators in women with physiologic pregnancy.

Conclusions: The results obtained in the conducted study indicate the significant increase of blood coagulation potential in the pregnant women with CKD. In our opinion, the global Thrombodynamic test is an objective method of investigation allowing clear differentiation among hyper-, hypo-, and isocoagulation, and identification of patterns of hemostatic disorders in pregnant women with CKD eventually determining the outcome of pregnancy and the health of a newborn child.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/new-criteria-for-assessing-hemostasis-disorders-in-pregnant-women-with-chronic-kidney-disease/