ProCGlobal and endogenous thrombin potential during pregnancy.

ABSTRACT

OBJECTIVE: Pregnancy is a hypercoagulable state. We evaluated global markers of coagulation activation, ProCGlobal (Siemens Healthcare Diagnostics, Eschborn, Germany) and endogenous thrombin potential (ETP), in pregnant women with and without low-molecular-weight (LMW) heparin prophylaxis. STUDY DESIGN: We prospectively followed 113 healthy women and 61 women receiving LMW heparin prophylaxis throughout pregnancy. ProCGlobal and ETP were measured in venous blood during the first, second, and third trimester. RESULTS: ProCGlobal decreased significantly throughout pregnancy in all women and was lower in anticoagulated women (P < .001 for all comparisons). ETP levels remained unchanged until the third trimester and then significantly decreased in all women. ETP was higher in anticoagulated women than in healthy women at all time points. CONCLUSION: ProCGlobal levels decrease throughout pregnancy. In pregnant women at high thrombotic risk, coagulation activation reflected by low ProCGlobal and high ETP levels is substantial despite LMW heparin prophylaxis.