Features of platelet hemostasis in pregnant women with protein C deficiency and protein S deficiency: a non-canonical assessment approach

The purpose of the study is to improve diagnostic methods for platelet hemostasis disorders in patients with thrombophilia (protein C deficiency and protein S deficiency) and complicated pregnancy.

Material and methods. The study involved 80 women aged 18 to 43 years (Me 37.7 [18; 43]), including 20 non-pregnant women (group 1 [control]) and 60 pregnant women at 12–14 weeks of gestation: 30 pregnant women with thrombophilia (protein S deficiency and protein C deficiency) (group 2) and 30 with physiological pregnancy (group 3). Standard hematological parameters and indices and the impedance aggregatometry method were used to assess the state of the platelet link of hemostasis. Morphodensitometric study of platelets was performed in real time on living unfixed and unstained cells using reagent-free quantitative phase imaging technology (QPI) based on the domestic optical hardware and software complex MIM 340 (OOO Shvabe, Moscow).

Results. The heterogeneity of the circulating platelet population was assessed in women outside pregnancy, pregnant women with thrombophilia, and in physiological pregnancy. The ratio of functional cell types (resting forms, platelets with low and high activity, degeneratively altered) was 63.2, 21.5, 13.2 and 2.1 %; 57.4, 25.2, 14.3 and 3.1 %; 61.1, 23.2, 13.4 and 2.3 %, respectively. The size parameters of circulating platelets in patients with thrombophilia differed in greater values of diameter and perimeter by 16.0 % and 21.9 % (p<0.05) in relation to the parameters outside pregnancy and by 7.4 % and 9.9 %, respectively, in relation to the group with physiological pregnancy. Correlation analysis of the correspondence of morphodensitometric parameters of platelets with the results of the study of their cell aggregation activity showed the presence of a connection between them.

Conclusion. The obtained data expand theoretical understanding of the functioning of the platelet link during physiological pregnancy and thrombophilia, demonstrate the effectiveness and feasibility of using reagent-free quantitative phase imaging technology for personalized assessment of platelet hemostasis in pregnant women. ionic activity of cells showed the presence of a connection between them.

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