During pregnancy, abnormalities in the hemostatic system may arise, contributing to intrauterine growth restriction (IUGR) in women at high risk for placental insufficiency. Objective: To evaluate the state of the hemostasis system in pregnant women who are at high risk for IUGR and placental insufficiency (PI). The assessment will focus on how the timing of detecting these derangements and implementing corrections affects the outcomes. Methods: The parameters of the hemostasis system were studied using a conventional coagulation test and thromboelastography (TEG) in 621 pregnant women at average and high risk of developing IUGR. These women were admitted for observation at different stages of pregnancy. The patients were categorized into four groups according to the timing of their admission during the pregnancy stages. Group I (n=195) included women observed starting from the first trimester, Group II (n=191) included women followed from the second trimester, and Group III (n=148) consisted of women observed from the third trimester. Group IV included women who had received preconception care (n=87). The control group (n=112) comprised women with a normal singleton pregnancy. Results: In pregnant women from Group I, early recognition and timely management of hemostasis abnormalities helped prevent the development of secondary thrombophilia. In Group II, the observation of hypercoagulation, platelet activation, and early signs of disseminated intravascular coagulation (DIC) syndrome prompted the use of low-molecular-weight heparins. In Group III, some patients experienced complications during pregnancy due to decompensated placental insufficiency, which led to DIC, requiring a multi-faceted treatment approach. Conclusion: Research shows that examining the hemostasis system during preconception care and early pregnancy can be beneficial for identifying potential abnormalities. Timely medical intervention to correct these issues can reduce the incidence of PI, prevent IUGR, and prolong the duration of pregnancy until a successful outcome is achieved. Timely medical interventions, such as those provided during antenatal care, can significantly reduce the occurrence of PI and IUGR and extend the pregnancy duration until a healthy outcome is achieved. Keywords: Pregnancy, fetal growth retardation, placental insufficiency, hemostasis, thromboelastogram
Kuneshko et al. (Wed,) studied this question.