Monitoring of Hemostatic Parameters for Early Prediction of First-trimester Miscarriage.

BACKGROUND Hypercoagulation starts as early as the first-trimester pregnancy and is a risk factor for thromboembolic events which are associated with miscarriage. Our study aimed to investigate coagulation, platelets, and fibrinolysis parameters alteration among trimester-specific normal pregnancy and first-trimester miscarriage patients. We also test the accuracy of hemostatic parameters determination for prediction of first-trimester miscarriage. METHODS Retrospective investigation of 50 women whose most recent pregnancy had ended in the first trimester and 54 age-matched consecutive normal pregnancy between 2016-2019. Furthermore, 51 non-pregnant, age-matched women were included in parallel to healthy controls. 12 Screening tests for coagulation and platelet parameters were assessed. RESULTS We found plasma levels of aPTT, FBG, TT were significantly prolonged or decreased in miscarriage subjects than the corresponding first phase in normal pregnancies. PT, INR, aPTT and D-dimer all shift back to normal in miscarriage patients compared with non-pregnant women. Shortened aPTT combined with TT and FBG can predicted the occurrence of first-trimester miscarriage with an AUC of 0.831. CONCLUSIONS Routine assessment of aPTT combined with TT and FBG is a low-cost, widely available marker for prediction of first-trimester miscarriage.