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| Correlation between the level of antithrombin III, protein C, or D-dimer and fetal growth restriction, and the clinical effect of anticoagulant therapy |
| Dongguan East Central Hospital(Dongguan Changping Hospital, Affiliated to Jinan University), Guangdong Province, 523573 |
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Abstract To explore the correlation between the level of antithrombin III (AT-III), protein C (PC), or D-dimer and fetal growth restriction (FGR), and to explore the clinical efficacy of anticoagulant therapy. Methods: 120 pregnant women with FGR were selected in study group, and 120 normal pregnant women were selected in control group. The plasma AT-III, PC, and D-mer levels of women in the two groups were detected, and which’s differences were analyzed between the two groups. The correlation between the level of AT-III, PC, or D-mer and FGR were also analyzed. The women in the study group were divided into group A and B by random number table method. 60 women in group A were treated with low molecular weight heparin anticoagulation, and 60 women in group B had received basic treatment only. The levels of plasma AT-III, PC, D-mer, and drag index (RI), pulsatility index (PI), and S/D value of umbilical artery flow, and the values of uterine height, head circumference, abdominal circumference, biparietal diameter, femur growth, and pregnancy outcomes of women in group A and B were observed before and after treatment. Results: The levels of plasma AT-III and PC of women in the study group were significant lower than those of women in the control group (P＜0.05). Spearman correlation analysis showed that the levels of plasma AT-III and PC were negatively correlated with FGR (F=-0.421, -0.502, P＜0.05), but D-dimer level was positively correlated with FGR (r=0.473, P＜0.05). The levels of AT-III and PC, and the values of uterine height, head circumference, abdominal circumference, biparietal diameter, and femur long growth, and neonatal birth weight in group A were significant higher than those in group B (P＜0.05), but the D-dimer level, and the values of RI, PI, and S/D of umbilical blood flow, and the rates of preterm birth and cesarean section in group A were significant lower than those in group B (P＜0.05). Conclusion: The AT-III and PC levels of women with FGR decrease, but their D-dimer level increase, which all may be involved in the pathogenesis of FGR. Low molecular weight heparin anticoagulant therapy can significantly reduce D-dimer level, increase AT-III and PC activity, promote fetal growth and development, improve cord blood dynamics, and can reduce the adverse pregnancy outcomes.
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