Changes in the Hemostatic System in Threatened Abortion and Their Correction

Introduction. The system of hemostasis during pregnancy, as is known, undergoes a number of compensatory adaptive, adaptive changes, the physiological role of which consists in stopping bleeding and preventing excessive blood loss in the rocks. These changes are a unique feature of the gestational process, supported by the fetoplacental complex. At the same time, the state of hypercoagulability under the certain unfavorable conditions can lead both to the development of thrombotic complications, and to a rapid transition to the hypocoagulation stage of the disseminated coagulation syndrome. The aim of the investigation was the assessment of the efficacy of therapy with the use of the Tranexam medication in women with threatened abortion at the gestation term of 8-21 weeks, accompanied by the chorionic/placental abruption. Materials and methods. A prospective study was conducted including 38 pregnant women at the gestational age of 8-21 weeks with a threat of abortion and a diagnosed detachment of the chorion or placenta. The control group consisted of 30 women at the gestational age of 8-21 weeks with the physiological course of pregnancy. Results. It was established that pathological activation of the blood fibrinolytic activity is always observed in patients with this pathology. Inclusion of the tranexamic acid medication in the plan of the pathogenetic therapy of women with bleedings in the first and second trimesters of pregnancy with the chorionic/placental abruption is pathogenetically substantiated and necessary, and allows to achieve a rapid normalization of hemostasis, promoting the successful prolongation of pregnancy. Application of the method of low-frequency vibrating piezoelectric hemoviscosimetry allows to control the duration of therapy with tranexam acid timely and adequately as well as its adequacy and efficacy. The used scheme of application of the medication (15.0 mg/kg intravenously once, then – oral administration of 500.0 mg (2 tablets) 3 times a day for 5 days) is effective. Additional studies allow timely and adequate monitoring of the duration of treatment with tranexamic acid, its adequacy and effectiveness. In our studies there were no complications as a result of the use of tranexamic acid, which confirms the data on its safety and effectiveness. Conclusions. Selective influence of “Tranexam” on the fibrinolytic activity of the blood and the absence of effects on the vascular platelet and plasma links of the hemostasis explains the absence of thrombotic complications in its use and high clinical efficacy.