I ka wā hāpai maʻamau, piʻi ka puka o ka puʻuwai a emi iho ke kūʻē ʻana o ke kino me ka piʻi ʻana o ka makahiki hāpai. Manaʻo nui ʻia e hoʻomaka ka piʻi ʻana o ka puka o ka puʻuwai i ka 8 a 10 mau pule o ka hāpai ʻana, a hiki i ka piko ma 32 a 34 mau pule o ka hāpai ʻana, ʻo ia hoʻi he 30% a 45% kiʻekiʻe ma mua o ka wā hāpai ʻole, a mālama i kēia pae a hiki i ka hānau ʻana. ʻO ka emi ʻana o ke kūʻē ʻana o ke kino peripheral e hōʻemi i ke kaomi arterial, a emi nui ke kaomi koko diastolic, a ākea ka ʻokoʻa o ke kaomi pulse. Mai 6 a 10 mau pule o ka hāpai ʻana, piʻi ka nui o ke koko o nā wahine hāpai me ka piʻi ʻana o ka makahiki hāpai, a piʻi aʻe ma kahi o 40% i ka hopena o ka hāpai ʻana, akā ʻoi aku ka nui o ka nui o ka plasma ma mua o ka helu o nā hunaola koko ʻulaʻula, piʻi ka plasma ma 40% a 50%, a piʻi nā hunaola koko ʻulaʻula ma 10% a 15%. No laila, i ka wā hāpai maʻamau, ua hoʻoheheʻe ʻia ke koko, i hōʻike ʻia e like me ka emi ʻana o ka viscosity koko, ka emi ʻana o ka hematocrit, a me ka piʻi ʻana o ka erythrocyte sedimentation rate [1].

Hoʻonui ʻia nā kumu hoʻohuihui koko Ⅱ, Ⅴ, VII, Ⅷ, IX, a me Ⅹ i ka wā hāpai, a hiki ke hōʻea i ka 1.5 a 2.0 mau manawa o ka maʻamau i ka hāpai waena a me ka hopena, a emi iho nā hana o nā kumu hoʻohuihui Ⅺ a me . Ua hoʻonui nui ʻia ʻo Fibrinopeptide A, fibrinopeptide B, thrombinogen, platelet factor Ⅳ a me fibrinogen, ʻoiai ua emi iho ka antithrombin Ⅲ a me ka protein C a me ka protein S. I ka wā hāpai, ua pōkole ka manawa prothrombin a me ka manawa prothrombin hapa i hoʻāla ʻia, a ua piʻi nui ka ʻike plasma fibrinogen, hiki ke hoʻonui i 4-6 g/L i ke kolu o ka trimester, ʻo ia hoʻi ma kahi o 50% ʻoi aku ka kiʻekiʻe ma mua o ka wā hāpai ʻole. Eia kekahi, ua hoʻonui ʻia ka plasminogen, ua hoʻolōʻihi ʻia ka manawa hoʻoheheʻe euglobulin, a ua hoʻolilo nā loli coagulation-anticoagulation i ke kino i kahi kūlana hypercoagulable, he mea maikaʻi ia no ka hemostasis maikaʻi ma hope o ka placental abruption i ka wā hānau. Eia kekahi, ʻo nā mea hypercoagulable ʻē aʻe i ka wā hāpai e komo pū ana me ka hoʻonui ʻia o ka cholesterol holoʻokoʻa, phospholipids a me triacylglycerols i loko o ke koko, androgen a me progesterone i hoʻokuʻu ʻia e ka placenta e hōʻemi i ka hopena o kekahi mau mea hoʻopaʻa koko coagulation, placenta, uterine decidua a me nā embryos. ʻO ke alo o nā mea thromboplastin, a me nā mea ʻē aʻe, hiki ke hoʻoulu i ke koko i loko o kahi kūlana hypercoagulable, a ua hoʻonui ʻia kēia loli me ka hoʻonui ʻana o ka makahiki gestational. ʻO ka hypercoagulation moderate kahi hana pale physiological, he mea pono ia e mālama i ka waiho ʻana o ka fibrin i loko o nā aʻa, ka paia uterine a me ka villi placental, kōkua i ka mālama ʻana i ka pono o ka placenta a hana i ka thrombus ma muli o ka wehe ʻana, a hoʻomaʻamaʻa i ka hemostasis wikiwiki i ka wā a ma hope o ka hānau ʻana. , he ʻano hana koʻikoʻi ia e pale ai i ke kahe koko postpartum. I ka manawa like o ka coagulation, hoʻomaka pū ka hana fibrinolytic lua e wehe i nā thrombus i loko o nā aʻa spiral uterine a me nā sinuses venous a hoʻolalelale i ka hana hou ʻana a me ka hoʻoponopono ʻana o ka endometrium [2].

Eia nō naʻe, hiki i kahi kūlana hypercoagulable ke hana i nā pilikia obstetric he nui. I nā makahiki i hala iho nei, ua ʻike ʻia nā haʻawina he nui nā wahine hāpai e maʻalahi i ka thrombosis. ʻO kēia kūlana maʻi o ka thromboembolism i nā wahine hāpai ma muli o nā kīnā genetic a i ʻole nā ​​​​​​mea pilikia i loaʻa e like me nā protein anticoagulant, nā mea coagulation, a me nā protein fibrinolytic ua kapa ʻia ʻo thrombosis. (thrombophilia), i ʻike ʻia hoʻi ʻo ke kūlana prothrombotic. ʻAʻole pono kēia kūlana prothrombotic e alakaʻi i ka maʻi thrombotic, akā hiki ke alakaʻi i nā hopena hāpai maikaʻi ʻole ma muli o nā kaulike ʻole i nā ʻano hana coagulation-anticoagulant a i ʻole ka hana fibrinolytic, microthrombosis o nā ʻōpū spiral uterine a i ʻole villus, e hopena ana i ka perfusion placental maikaʻi ʻole a i ʻole infarction, e like me Preeclampsia, placental abruption, placental infarction, disseminated intravascular coagulation (DIC), fetal growth restriction, recurrent miscarriage, stillbirth a me ka hānau mua ʻana, a pēlā aku, hiki ke alakaʻi i ka make ʻana o ka makuahine a me ka perinatal i nā hihia koʻikoʻi.