I te wā hapūtanga noa, ka piki ake te putanga o te ngākau, ā, ka heke te ātete ā-taha i te pikinga ake o te tau hapūtanga. E whakaponohia whānuitia ana ka tīmata te pikinga o te putanga o te ngākau i te 8 ki te 10 wiki o te hapūtanga, ā, ka eke ki tōna taumata teitei i te 32 ki te 34 wiki o te hapūtanga, he 30% ki te 45% teitei ake i tērā i te wā kāore i te hapūtanga, ā, ka mau tonu tēnei taumata tae noa ki te whānautanga. Mā te hekenga o te ātete ā-taha ka whakaitihia te pēhanga uaua, ā, ka tino heke te pēhanga toto diastolic, ā, ka whānui haere te rerekētanga o te pēhanga o te manawa. Mai i te 6 ki te 10 wiki o te hapūtanga, ka piki ake te nui o te toto o ngā wāhine hapūtanga i te pikinga ake o te tau hapūtanga, ā, ka piki ake mā te 40% i te mutunga o te hapūtanga, engari ko te pikinga o te nui o te toto toto he nui ake i te maha o ngā toto toto whero, ka piki ake te toto ...

Ka piki ake ngā āhuatanga toto toto Ⅱ, Ⅴ, VII, Ⅷ, IX, me Ⅹ i te wā e hapu ana, ā, ka eke ki te 1.5 ki te 2.0 ngā wā o te tikanga i waenganui me te mutunga o te haputanga, ā, ka heke te mahi a ngā āhuatanga toto toto Ⅺ me . Ka piki ake te Fibrinopeptide A, te fibrinopeptide B, te thrombinogen, te āhuatanga pereti Ⅳ me te fibrinogen, i te wā e heke ana te antithrombin Ⅲ me te pūmua C me te pūmua S. I te wā e hapu ana, ka whakapotohia te wā prothrombin me te wā prothrombin wāhanga whakahohe, ā, ka piki ake te ihirangi fibrinogen plasma, ka piki ake ki te 4-6 g/L i te toru o ngā marama, he 50% teitei ake i tērā i te wā kāore i te hapu. Hei tāpiri, ka piki ake te plasminogen, ka roa ake te wā whakarewa euglobulin, ā, nā ngā huringa toto toto-anticoagulation i hanga te tinana ki te āhua toto totoka nui, he mea pai ki te hemostasis whai hua i muri i te pakaru o te whenua i te wā whānau. Hei tāpiritanga, ko ētahi atu āhuatanga totoka nui i te wā e hapu ana ko te pikinga o te cholesterol katoa, ngā phospholipids me ngā triacylglycerols i roto i te toto, ko te androgen me te progesterone i tukuna e te placenta ka whakaiti i te pānga o ētahi aukati totoka nui, te placenta, te uterine decidua me ngā kukune. Ko te noho mai o ngā matū thromboplastin, me ētahi atu, ka taea te whakatairanga i te toto kia noho ki roto i te āhua totoka nui, ā, ka nui ake te kino o tēnei huringa me te pikinga o te tau haputanga. Ko te totoka nui ngawari he tikanga tiaki ā-tinana, he mea whai hua ki te pupuri i te whakatakotoranga fibrin i roto i ngā uaua, te pakitara uterine me ngā villi placenta, ka āwhina ki te pupuri i te pono o te placenta me te hanga thrombus nā te tangohanga, me te whakahaere i te tere o te hemostasis i te wā me muri i te whānautanga. , he tikanga nui hei ārai i te totoka i muri i te whānautanga. I te wā kotahi o te totoka nui, ka tīmata hoki te mahi fibrinolytic tuarua ki te tango i ngā thrombus i roto i ngā uaua porowhita uterine me ngā sinuses venous me te whakateretere i te whakahoutanga me te whakatikatika o te endometrium [2].

Heoi, ka taea hoki e te āhua totoka nui te whakararu i te whānautanga. I ngā tau tata nei, kua kitea e ngā rangahau he maha ngā wāhine hāpu e pāngia ana e te thrombosis. Ko tēnei āhua mate o te thromboembolism i roto i ngā wāhine hāpu nā ngā hapa ira, nā ngā āhuatanga mōrearea rānei pērā i ngā pūmua anticoagulant, ngā āhuatanga totoka, me ngā pūmua fibrinolytic ka kiia ko te thrombosis. (thrombophilia), e mōhiotia ana ko te āhua prothrombotic. Kāore tēnei āhua prothrombotic e arahi ki te mate thrombotic, engari ka arahi pea ki ngā hua kino o te hāputanga nā te kore taurite o ngā tikanga totoka-anticoagulation, te mahi fibrinolytic rānei, te microthrombosis o ngā uaua porowhita o te uterine, te villus rānei, ka hua ake te ngoikore o te rere o te toto ki te whenua, tae noa ki te infarction, pērā i te Preeclampsia, te abruption o te whenua, te infarction o te whenua, te disseminated intravascular coagulation (DIC), te aukati i te tipu o te kukune, te materoto auau, te whānautanga mate me te whānautanga wawe, me ētahi atu, ka taea te arahi ki te mate o te whaea me te perinatal i ngā take kino.