Coupled Model of Blood Volume and Activated Clotting Factor Concentration during Childbirth ?

摘要

Obstetric patients show an increased risk of developing venous thromboembolism (VTE). Modeling the changes that occur during and after delivery may help determine which patients will develop VTE and when they might be likely to develop this dangerous complication after delivery Combining a model of blood volume changes with a model of activated clotting factor concentrations, which are both affected during delivery can identify scenarios that may lead to an increased risk of developing clots in the venous vascular space. This Ordinary Differential Equation (ODE) model recapitulates known phenomena including an elevated coagulation response during delivery and hemorrhage leading to increased clotting factor concentration in the vascular space. The simulation from normal activation without hemorrhage results in a spike in clotting factors in the vascular space to reestablish hemostasis after delivery. With twice the activation rate, simulations show elevated and extended duration of activated clotting factor presence in the vascular space. With response to a hemorrhage with normal activation, the resulting elevation and duration is further increased. This model, when tailored to individual patients, could lead to the development of a VTE risk assessment tool for clinicians to help mitigate and reduce an individual’s risk of developing this deadly complication.