A well functioning hemostasis depends on the well-balanced interaction between many procoagulatory and inhibiting factors of the coagulation and the fibrinolytic system. During normal pregnancy this balance is shifted towards a state of hypercoagulability [1], which is more marked around term and in the immediate post partum period [2].While numerous studies have dealt with markers of thrombin generation during pregnancy, only one investigated the endogenous thrombin potential [ETP] during pregnancy [3]. In this first prospective and systematic evaluation of coagulation and fibrinolytic system activation in healthy women during uncomplicated pregnancy Eichinger et al. determined the ETP over the course of pregnancy. This was done by a manual method and no other parameters of thrombin generation such as peak or time to peak were analyzed. Surprisingly, the ETP remained unchanged in this study and the author suggested that the capacity of the plasma to generate thrombin after in vitro activation of the clotting system is not affected by pregnancy.The aim of our study was to investigate thrombin generation during normal uncomplicated pregnancy in more detail by using the calibrated automated thrombography developed by Hemker [4] and to compare results of thrombin generation with conventional markers of clotting and clotting activation.
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