Contributions
Abstract: P14
Type: Poster presentation
Presentation during EHA Scientific Conference on Bleeding Disorders:
On Friday, September 16, 2016 from 14:00 - 15:30
Location: Cristal + Coral
Background
Platelet dysfunction is implicated in uteroplacental disorders. During the early stages of gestation platelets have important roles in the process of placentation. Platelet function contributes to enhanced haemostasis at delivery. However, there is limited data on the changes of platelet function during normal pregnancy. Understanding physiological changes of platelet aggregation during different stages of pregnancy is helpful for better understanding of pathophysiology of abnormal placentation.
Aims
To assess platelet aggregation during three trimesters of pregnancy and immediate postnatal period in normal healthy women compared to control non-pregnant group.
Design
Cross-sectional cohort study including a total of 46 women: 10 participants for each trimester, 10 postnatal cases and 6 control non-pregnant women. Case selection was based on specific inclusion criteria.
Methods
30mL of venous blood was obtained from each participant following consent. Light transmission aggregometry was performed with Dual channel Payton 600B aggregometer using six platelet aggregating agonist (epinephrine, adenosine triphosphate, collagen, ristocetin, arachidonic acid and U46619).
Results
The findings included reduced secondary aggregation curve appearance in pregnant and postnatal women when compared to control group, which was most apparent in the third trimester. Compared to non-pregnant controls, platelet aggregation induced by ADP and collagen were reduced during third trimester while epinephrine induced aggregation was reduced during the first trimester.
Conclusion
Reduced platelet reactivity in response to epinephrine during early pregnancy can be considered as a mechanism to reduce thrombosis and allow normal placentation while diminished ADP and collagen induced aggregation in third trimester could be a compensatory mechanism since pregnancy associated with hyper-coagulation particularly in late stages.
References
1. ASKIE, L. M., DULEY, L., HENDERSON-SMART, D. J. & STEWART, L. A. 2007. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet, 369, 1791-8.
2. BICK, R. L. & HOPPENSTEADT, D. 2005. Recurrent miscarriage syndrome and infertility due to blood coagulation protein/platelet defects: a review and update. Clin Appl Thromb Hemost, 11, 1-13.
3. BREMME, K. A. 2003. Haemostatic changes in pregnancy. Best Pract Res Clin Haematol, 16, 153-68.
4. BRENNER, B. 2004. Haemostatic changes in pregnancy. Thromb Res, 114, 409-14.
5. BURKE, N., FLOOD, K., MURRAY, A., COTTER, B., DEMPSEY, M., FAY, L., DICKER, P., GEARY, M., KENNY, D. & MALONE, F. 2013. Platelet reactivity changes significantly throughout all trimesters of pregnancy compared with the nonpregnant state: a prospective study. Bjog.
6. DAMRON, D. P., BOUCHARD, B. A., SHAPIRO, R. E., SCHONBERG, A. L. & BERNSTEIN, I. M. 2004. Platelet activation, sympathetic tone, and plasma volume in nulligravid women of reproductive age. Obstet Gynecol, 103, 931-6.
Abstract: P14
Type: Poster presentation
Presentation during EHA Scientific Conference on Bleeding Disorders:
On Friday, September 16, 2016 from 14:00 - 15:30
Location: Cristal + Coral
Background
Platelet dysfunction is implicated in uteroplacental disorders. During the early stages of gestation platelets have important roles in the process of placentation. Platelet function contributes to enhanced haemostasis at delivery. However, there is limited data on the changes of platelet function during normal pregnancy. Understanding physiological changes of platelet aggregation during different stages of pregnancy is helpful for better understanding of pathophysiology of abnormal placentation.
Aims
To assess platelet aggregation during three trimesters of pregnancy and immediate postnatal period in normal healthy women compared to control non-pregnant group.
Design
Cross-sectional cohort study including a total of 46 women: 10 participants for each trimester, 10 postnatal cases and 6 control non-pregnant women. Case selection was based on specific inclusion criteria.
Methods
30mL of venous blood was obtained from each participant following consent. Light transmission aggregometry was performed with Dual channel Payton 600B aggregometer using six platelet aggregating agonist (epinephrine, adenosine triphosphate, collagen, ristocetin, arachidonic acid and U46619).
Results
The findings included reduced secondary aggregation curve appearance in pregnant and postnatal women when compared to control group, which was most apparent in the third trimester. Compared to non-pregnant controls, platelet aggregation induced by ADP and collagen were reduced during third trimester while epinephrine induced aggregation was reduced during the first trimester.
Conclusion
Reduced platelet reactivity in response to epinephrine during early pregnancy can be considered as a mechanism to reduce thrombosis and allow normal placentation while diminished ADP and collagen induced aggregation in third trimester could be a compensatory mechanism since pregnancy associated with hyper-coagulation particularly in late stages.
References
1. ASKIE, L. M., DULEY, L., HENDERSON-SMART, D. J. & STEWART, L. A. 2007. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet, 369, 1791-8.
2. BICK, R. L. & HOPPENSTEADT, D. 2005. Recurrent miscarriage syndrome and infertility due to blood coagulation protein/platelet defects: a review and update. Clin Appl Thromb Hemost, 11, 1-13.
3. BREMME, K. A. 2003. Haemostatic changes in pregnancy. Best Pract Res Clin Haematol, 16, 153-68.
4. BRENNER, B. 2004. Haemostatic changes in pregnancy. Thromb Res, 114, 409-14.
5. BURKE, N., FLOOD, K., MURRAY, A., COTTER, B., DEMPSEY, M., FAY, L., DICKER, P., GEARY, M., KENNY, D. & MALONE, F. 2013. Platelet reactivity changes significantly throughout all trimesters of pregnancy compared with the nonpregnant state: a prospective study. Bjog.
6. DAMRON, D. P., BOUCHARD, B. A., SHAPIRO, R. E., SCHONBERG, A. L. & BERNSTEIN, I. M. 2004. Platelet activation, sympathetic tone, and plasma volume in nulligravid women of reproductive age. Obstet Gynecol, 103, 931-6.