Haemostatic Changes during Pregnancy and Puerperium in Kano, North-Western Nigeria

Abstract

Aim: Normal pregnancy is associated with haemostatic changes which have been linked to a complex physiological adaptation but these changes return to that of non-pregnant state at about 4 weeks of post-delivery. This study was undertaken to monitor the haemostatic changes during pregnancy and puerperium in North-Western Nigeria. Materials and methods: Ten pregnant women, aged 17-40 years were monitored for haemostatic changes from the first trimester to 6 weeks after delivery between August 2010 and October 2011 at Aminu Kano Teaching Hospital, Kano. Blood samples collected for platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation products (FDP), fibrinogen level, d-dimer, protein C, factors VII and VIII activities were analysed using standard laboratory techniques. Results: There were significantly lower values of platelet count, factor VIII concentration and protein C activity of 275.5 ± 4.14 × 109 /L, 93.2 ± 31.6% and 56.7 ± 13.4% during pregnancy compared to 378.5 ± 74.0 × 109 /L, 122.5 ± 3.0% and 97.1 ± 14.6% respectively, during puerperium. The values of PT, factor VII concentration, fibrinogen level, FDP and D-dimer concentrations during pregnancy and puerperium showed no significant differences (P>0.05). Factors VII and VIII concentrations increased significantly as gestation advanced (P<0.05). Conclusion: The study concluded that changed values of platelet count, protein C and factor VIII concentrations during pregnancy, normalized at puerperal period while advanced gestation may pose a threat to pregnancy. It is recommended that protein C, factors VII and VIII concentrations be monitored during pregnancy to minimize thrombotic effect.