obstetric haemorrhage, hemostasis, multiparous women.

CONDITION OF COAGULATION HEMOSTASIS AMONG WOMEN, WHO ARE IN THE RISK GROUP BY POSTPARTUM HAEMORRHAGE DEPENDING ON CHILDBIRTHS PARITY

Author(s): Bapayeva G.B., Kulbayeva S.N.

DOI: 10.34689/SH.2015.17.1.007

Background: Obstetric haemorrhage is the important issue of obstetrics and one of the major causes of maternal mortality and morbidity in the world. Multiparous women take up a large proportion among dead women. More than 2/3 of blood loss, including threatening the mother’s life, is associated with disorders of hemostasis. The aim: to evaluate the coagulation system in women with risk factors for postpartum haemorrhage depending on childbirths parity. Methods: 126 pregnant women were examined, i.e. 96 pregnant women of haemorrhage risk group and 30 pregnant women with physiologic gestation. Pregnant women of risk group were divided into 2 groups depending on outcome: basic and comparative groups. Basic group included 65 women, who had haemorrhage during postpartum period, i.e. 37 multipara women were in the 1st subgroup, and 28 primipara and bipara women were in the II subgroup. Comparative group included 31 women of risk group without postpartum haemorrhage. Results: Women with pospartum haemorrhage had initially the hypercoagulation, which manifested in a significant decrease of APTT, elongation of PPT, relative hyperfibrinogenemia (p <0.001). Hypercoagulation was replaced by hypocoagulation during delivery. There was a significant reduction in the level of fibrinogen, platelets, elongation of thrombin, prothrombin and activated partial thromboplastin time (p <0.001). It indicated the transition from chronic phase of disseminated intravascular coagulation in acute one and manifested by massive blood loss. These changes were greater with increasing of childbirths parity. Conclusion: Risk of coagulopathy hemorrhage increases with the increasing of childbirths parity, for which reason, multiparous women should be referred to risk group of this complication. This group of pregnant women need in the differentiated approach to the treatment of obstetric haemorrhage

G. B. Bapayeva 1, S. N. Kulbayeva 2 1 National Research Center for Maternal and Child, Astana, Kazakhstan 2 South-Kazakhstan state pharmaceutical academy, Shymkent, Kazakhstan

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Key words: obstetric haemorrhage, hemostasis, multiparous women.

Category of articles: Original article

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