A Review of Hemostasis in Normal Pregnancy and Puerperium

Abstract

Significant alterations are seen in hemostatic system during normal pregnancy and puerperium. Overall, it is a state of hypercoagu-lability and hypofibrinolysis mitigating the risk of severe bleeding during placental separation at delivery. On the flip side, it threatens a pregnant woman for thrombosis with the risk being four to six folds more in comparison to a non-pregnant woman. It is important to understand the hemostatic changes in normal pregnancy by all health care providers who manage pregnant women in obstetric wards, trauma, anesthesia and other circumstances. This review describes the changes in qualitative and quantitative changes in platelet, clotting factors, anticoagulants and fibrinolysis during normal pregnancy and puerperium.