Monitoring of hemostatic parameters for early prediction of first-trimester miscarriage

Abstract

Background

Hypercoagulation starts as early as the first-trimester pregnancy and is a risk factor for thromboembolic events which are associated with miscarriage. Our study aimed to investigate coagulation, platelets, and fibrinolysis parameters alteration amongst trimester-specific normal pregnancy and first-trimester miscarriage patients. We also test the accuracy of haemostatic parameters determination for prediction of first-trimester miscarriage.

Methods

Retrospective investigation of 50 women whose most recent pregnancy had ended in the first trimester and 54 age-matched consecutive normal pregnancy between 2016 and 2019. Furthermore, 51 non-pregnant, age-matched women were included in parallel to healthy controls. Twelve screening tests for coagulation and platelet parameters were assessed.

Results

We found plasma levels of aPTT, FBG, and TT were significantly prolonged or decreased in miscarriage subjects than the corresponding first phase in normal pregnancies. PT, INR, aPTT, and d-dimer all shift back to normal in miscarriage patients compared with non-pregnant women. Shortened aPTT combined with TT and FBG can predicted the occurrence of first-trimester miscarriage with an AUC of 0.831.

Conclusions

Routine assessment of aPTT combined with TT and FBG is a low-cost, widely available marker for prediction of first-trimester miscarriage.

Keywords:

• Coagulation
• first-trimester miscarriage
• haemostatic parameters
• platelets
• pregnancy
• screening

Ethics approval

Approval for the study was obtained from the Local Research Ethics Committee (EA 2019(9), 11-28-2019).

Data availability statement

This is a retrospective study for which data were derived from the Third Affiliated Hospital of Chongqing Medical University. All relevant data are available within the manuscript.

Disclosure statement

The authors report no conflict of interest to this study.

Additional information

Funding

This work was financially supported by Youth Seed Grant from Third Affiliated Hospital of Chongqing Medical University [Grant no: KY08032].