{"title":"Coagulation and fibrinolytic system of umbilical venous blood in hyper-coiled umbilical cord: A single center cohort study","authors":"Shota Saji , Masatomo Doi , Junki Koike , Nao Suzuki , Junichi Hasegawa","doi":"10.1016/j.placenta.2025.02.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to clarify whether the coagulation-fibrinolytic system is activated in a hyper-coiled umbilical cord (HCC).</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at a single perinatal center in Japan, including singleton pregnant women who delivered after 37 weeks of gestation between January and July 2024. Umbilical venous blood was collected immediately after birth and before placental delivery. The coagulation and fibrinolytic systems were measured, and variables were compared between patients with and without HCC.</div></div><div><h3>Results</h3><div>As a variable of cell blood count and hemostatic function, platelet concentration was significantly lower in the HCC group [median (range): 25.5 (17.3–32.1) vs 30.4 (18.5–39.55) x100000/μl, p = 0.020]. For coagulation variables, fibrinogen concentration [105 (63–116) vs 137.5 (56–229) mg/dl, p < 0.001] and antithrombin III [35 (27–51) vs 47.5 (31–62) %, p = 0.022] were significantly lower in the HCC group. Regarding fibrinolytic variables, plasmin inhibitor complex concentration was significantly higher in HCC group [1.3 (1.0–6.9) vs 0.7 (0.3–5.2) μg/ml, p = 0.036]; however, plasminogen concentration was significantly lower in HCC group [40 (32–46) vs 50 (25–64), p < 0.001].</div></div><div><h3>Discussion</h3><div>This is the first report where the coagulation-fibrinolytic system in the umbilical venous blood in cases with HCC was demonstrated. Findings reveal an activated coagulation-fibrinolytic system even in cases without severe fetal growth restriction due to HCC after 37 weeks of gestation.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 9-13"},"PeriodicalIF":3.0000,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Placenta","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0143400425000360","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DEVELOPMENTAL BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
We aimed to clarify whether the coagulation-fibrinolytic system is activated in a hyper-coiled umbilical cord (HCC).
Methods
This prospective cohort study was conducted at a single perinatal center in Japan, including singleton pregnant women who delivered after 37 weeks of gestation between January and July 2024. Umbilical venous blood was collected immediately after birth and before placental delivery. The coagulation and fibrinolytic systems were measured, and variables were compared between patients with and without HCC.
Results
As a variable of cell blood count and hemostatic function, platelet concentration was significantly lower in the HCC group [median (range): 25.5 (17.3–32.1) vs 30.4 (18.5–39.55) x100000/μl, p = 0.020]. For coagulation variables, fibrinogen concentration [105 (63–116) vs 137.5 (56–229) mg/dl, p < 0.001] and antithrombin III [35 (27–51) vs 47.5 (31–62) %, p = 0.022] were significantly lower in the HCC group. Regarding fibrinolytic variables, plasmin inhibitor complex concentration was significantly higher in HCC group [1.3 (1.0–6.9) vs 0.7 (0.3–5.2) μg/ml, p = 0.036]; however, plasminogen concentration was significantly lower in HCC group [40 (32–46) vs 50 (25–64), p < 0.001].
Discussion
This is the first report where the coagulation-fibrinolytic system in the umbilical venous blood in cases with HCC was demonstrated. Findings reveal an activated coagulation-fibrinolytic system even in cases without severe fetal growth restriction due to HCC after 37 weeks of gestation.
期刊介绍:
Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.