Evaluation of Changes in Haemostatic Parameters in Pregnancy and Puerperium in Women attending Antenatal Clinic at Rivers State University Teaching Hospital, Nigeria

This was a cross-sectional study carried out in Rivers State University Teaching Hospital, Port Harcourt with the aim of determining the Changes in Haemostatic Parameters in Pregnancy and puerperium.A total of 500 age-matched apparently healthy women of reproductive age, which consisted of 200 (40%) pregnant women, 200 (40%) puerperium mothers and 100 (20%) non-pregnant women who served as controls were studied.Their ages ranged from 16 to 41 years (mean 27.4 ± 4.3 years).The Platelets count, prothrombin time (PT), partial thromboplastin time with kaolin (PTTK) and fibrinogen concentration were determined using Standard Manual Techniques.Platelets count was carried out as described by Bain and Seed, PT and PTTK by Quick's methods while modified Clauss Method was used in the determination of Fibrinogen concentration.The pregnant women had significantly lower values of platelet count, 203.89 ± 65.2 × 10 9 /L (range, 78-416) as compared to 257.0 ± 69.0 × 10 9 /L, (range, 90-396 × 10 9 /L,) of the non-pregnant subjects and the 249.1 ± 75.0 × 10 9 /L, (range, 95-406 × 10 9 /L) of the puerperium women (F = 28.437;P < 0.05).The prevalence of thrombocytopenia among the pregnant, puerperium mothers and non-pregnant control women were 53(26.5%),15(7.5%) and 12(12.0%)respectively.The mean PT, 15.48 ±2.49seconds (range, 14-16 seconds) of the non-pregnant control women were significantly higher than the mean PT, 11.36 ± 3.12 seconds (range, 10-16 seconds) of the pregnant women and the 14.28 ± 4.22 seconds (range, 13-16 seconds) of the puerperium women (F = 57.843;P < 0.05).The international normalized ratio (INR) of the pregnant women as compared to the non-pregnant and puerperium women were not statistically significant (F = 2.206; P > 0.05).The mean PTTK of the pregnant women, 44.1 ± 7.2 seconds (range, 43.3-46.1 seconds) were significantly higher than the PTTK of the non-pregnant women, 39.4 ± 8.1 seconds (range, 38.4-44.3seconds) and the puerperium women, 40.32 ± 6.4 seconds (range, 41.3-43.3seconds) (F = 20.512;P < 0.05).The mean fibrinogen concentration, 4.4 ± 0.80 g/L (range, 2.9 -5.1 g/L) of the pregnant women were significantly higher than the mean fibrinogen concentration, 3.6 ± 0.88 g/L (range, 2.8-4.4 g/L) of the puerperium women and the non-pregnant control women, 2.6 ± 0.72 g/L (range, 2.6-4.3 g/L) (F = 164.877;P < 0.05).The results point towards a hypercoagulable state in pregnant women, which is normal during pregnancy.