Abstract | BACKGROUND/AIMS: METHODS: The platelet count, AT-III activity, and the serum level of aspartate aminotransferase were determined weekly or biweekly in 237 women with twin pregnancies in a longitudinal and partly prospective study. RESULTS: Both AT-III activity and the platelet count decreased gradually in the last month of pregnancy, irrespective of the presence or absence of clinical signs of pre-eclampsia. A perinatal elevation in aspartate aminotransferase occurred in 36 (15%) of 237 women. The risk of a perinatal elevation in aspartate amino- transferase increased as the antenatal AT-III activity and/or the platelet count decreased. Pre-eclampsia developed in 60 women (25%). The relative risk of a perinatal aspartate aminotransferase elevation (95% confidence interval) for the 60 women with pre-eclampsia, the 60 women with a platelet count < or = the 25th percentile (164 x 10(9)/1), and the 60 women with AT-III activity < or = the 25th percentile (76% of normal) was 1.9 (1.0 to 3.4), 4.1 (2.3 to 7.5), and 5.9 (3.2 to 11.1), respectively, compared with the remaining 177 women. CONCLUSIONS: AT-III activity and platelet count gradually decreased in the last month of twin pregnancies. A perinatal aspartate aminotransferase elevation was preceded by marked decreases in these parameters in women with twin pregnancies. The monitoring of AT-III activity and platelet count in women who exhibit a gradual decline in these parameters may help to avoid the development of severe HELLP syndrome.
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Authors | H Minakami, T Watanabe, A Izumi, S Matsubara, T Koike, M Sayama, I Moriyama, I Sato |
Journal | Journal of hepatology
(J Hepatol)
Vol. 30
Issue 4
Pg. 603-11
(Apr 1999)
ISSN: 0168-8278 [Print] Netherlands |
PMID | 10207801
(Publication Type: Journal Article)
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Chemical References |
- Antithrombin III
- Aspartate Aminotransferases
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Topics |
- Adult
- Antithrombin III
(analysis, metabolism)
- Aspartate Aminotransferases
(blood)
- Cesarean Section
- Female
- Gestational Age
- HELLP Syndrome
(blood)
- Humans
- Infant, Newborn
- Longitudinal Studies
- Platelet Count
- Pre-Eclampsia
(blood)
- Pregnancy
(blood)
- Pregnancy Complications, Hematologic
(blood)
- Pregnancy Trimester, Third
- Reference Values
- Risk Assessment
- Thrombocytopenia
(blood)
- Twins
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