PREGNANCY AND DELIVERY IN WOMEN WITH ANGIOHEMOPHILIA
Keywords:pregnant, angiohemophilia, Willebrand factor, coagulogram
Insufficiency of the coagulation system during pregnancy can endanger the health of patients with angiohemophilia and the fetus. The goal is to estimate changes in blood coagulation parameters as pregnancy progresses in patients with angiohemophilia. Materials and methods. 15 pregnant women with mild angiohemophilia (main group) and 20 pregnant women without hereditary and gestational coagulopathy (control group) were examined. Research methods included survey and examination of pregnant women, anamnestic data, analysis of information from pregnant women's cards. Coagulological examination is performed according to 17 parameters. Results. The average age of the main group of pregnant women was 28.78±3.61 years, the average age was 12.7±1.05 years. Significant differences between the groups were noted in the frequency of menorrhagia (р=0.006) and dysmenorrhea (р<0.001). A significant difference in the frequency of chronic endometritis (р<0.001), vaginitis (р=0.015), anemia (р=0.006) and gastrointestinal diseases (р=0.015) was revealed in the main group compared to the control group. Complications occurred in 46.7% of pregnant women in the first trimester, in 53.3% of pregnant women in the second trimester, and in 60.0% of pregnant women in the third trimester. The chance of complications in the III trimester was high (OR=0.762, 95% CI 0.179-3.241, р<0.05). Head presentation was determined in 80.0%, pelvic presentation - in 20.0% of cases. In the III trimester of patients of the main group, prothrombin time and activated partial thrombin time significantly exceeded the control ones (р<0.001), a significant increase in factor VII (p=0.037) and a decrease in factor VIII (р<0.001) were revealed. Conclusion. The clinical status of pregnant women with angiohemophilia is characterized by complicated gynecological and obstetric anamnesis and changes in all parameters of the coagulogram in the III trimester.
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