Ekukhulelweni okuvamile, ukuphuma kwenhliziyo kuyenyuka futhi ukumelana ne-peripheral kuncipha ngokuya ngeminyaka yokukhulelwa.Ngokuvamile kunenkolelo yokuthi ukukhishwa kwenhliziyo kuqala ukwanda emavikini angu-8 kuya kwayi-10 okukhulelwa, futhi kufinyelela inani eliphakeme emasontweni angama-32 kuya kwangu-34 okukhulelwa, okungama-30% kuya ku-45% aphezulu kunalawo angakakhulelwa, futhi agcine leli zinga kuze kube ukulethwa.Ukwehla kokumelana nemithambo ye-peripheral kunciphisa umfutho we-arterial, futhi umfutho wegazi we-diastolic wehla kakhulu, futhi umehluko we-pulse pressure uyanda.Kusukela emavikini ayisi-6 kuye kwayi-10 okukhulelwa, umthamo wegazi labesifazane abakhulelwe ukhuphuka ngokukhula kweminyaka yobudala, futhi ukhuphuka cishe ngama-40% ekupheleni kokukhulelwa, kodwa ukwanda komthamo we-plasma kudlula kude inani lamangqamuzana abomvu egazi, i-plasma. inyuka ngo-40% ukuya ku-50%, kanti amangqamuzana abomvu egazi akhuphuka ngo-10% kuya ku-15%.Ngakho-ke, ekukhulelweni okuvamile, igazi liyahlanjululwa, libonakale njengokuncipha kwe-viscosity yegazi, ukuncipha kwe-hematocrit, kanye nenani le-erythrocyte sedimentation elikhulayo [1].

Izici zokujiya kwegazi Ⅱ, Ⅴ, VII, Ⅷ, IX, kanye Ⅹ zonke ziyanda ngesikhathi sokukhulelwa, futhi zingafinyelela izikhathi ezingu-1.5 kuya kwezingu-2.0 zokuvamile phakathi nokukhulelwa okuphakathi nasekupheleni, kanye nemisebenzi yezici zokujiya Ⅺ kanye Ⅹ nokuncipha.I-Fibrinopeptide A, i-fibrinopeptide B, i-thrombinogen, i-platelet factor Ⅳ kanye ne-fibrinogen inyuke kakhulu, kuyilapho i-antithrombin Ⅲ ne-protein C kanye ne-protein S yehla.Ngesikhathi sokukhulelwa, isikhathi se-prothrombin nesikhathi esicushiwe se-prothrombin esiyingxenye siyafinyezwa, futhi okuqukethwe kwe-plasma fibrinogen kukhuphuka kakhulu, okungase kwenyuke kufinyelele ku-4-6 g/L ku-trimester yesithathu, okungaba ngama-50% aphezulu kunalowo ongakhulelwe. isikhathi.Ukwengeza, i-plasminogen yanda, isikhathi sokuchithwa kwe-euglobulin sandiswa, futhi izinguquko ze-coagulation-anticoagulation zenza umzimba ube nesimo se-hypercoagulable, okwakuzuzisa ukukhishwa kwe-hemostasis ephumelelayo ngemva kokuphuma kwe-placenta ngesikhathi sokubeletha.Ngaphezu kwalokho, ezinye izici ezibangelwa ukuqina kwe-hypercoagulable ngesikhathi sokukhulelwa zihlanganisa ukwanda kwe-cholesterol ephelele, i-phospholipids kanye ne-triacylglycerols egazini, i-androgen ne-progesterone ekhishwa yi-placenta kunciphisa umphumela we-blood coagulation inhibitors, i-placenta, i-uterine decidua kanye nemibungu.Ukuba khona kwezinto ze-thromboplastin, njll., kungakhuthaza igazi ukuba libe sesimweni se-hypercoagulable, futhi lolu shintsho luthuthukisiwe ngokukhula kweminyaka yokukhulelwa.I-hypercoagulation emaphakathi iyisilinganiso sokuzivikela somzimba, esizuzisa ukugcina i-fibrin ehlala emithanjeni, odongeni lwesibeletho kanye ne-placenta villi, kusiza ukugcina ubuqotho be-placenta futhi yenze i-thrombus ngenxa yokukhumula, futhi kube lula ukopha ngokushesha ngesikhathi nangemva kokubeletha., kuyindlela ebalulekile yokuvimbela ukopha kwangemva kokubeletha.Ngesikhathi esifanayo sokuhlangana, umsebenzi wesibili we-fibrinolytic nawo uqala ukususa i-thrombus emithanjeni ye-uterine spiral kanye nezono ze-venous futhi kusheshiswe ukuvuselelwa nokulungiswa kwe-endometrium [2].

Kodwa-ke, isimo se-hypercoagulable singabangela nezinkinga eziningi zokubelethisa.Eminyakeni yamuva nje, ucwaningo luye lwathola ukuthi abesifazane abaningi abakhulelwe bathambekele ku-thrombosis.Lesi simo sesifo se-thromboembolism kwabesifazane abakhulelwe ngenxa yokukhubazeka kwezakhi zofuzo noma izici eziyingozi ezitholakalayo njengamaprotheni e-anticoagulant, izici ze-coagulation, namaprotheni e-fibrinolytic abizwa ngokuthi i-thrombosis.(i-thrombophilia), eyaziwa nangokuthi isimo se-prothrombotic.Lesi simo se-prothrombotic asiholeli ngempela esifweni se-thrombotic, kodwa singase siholele emiphumeleni yokukhulelwa engemihle ngenxa yokungalingani kwezinqubo ze-coagulation-anticoagulation noma umsebenzi we-fibrinolytic, i-microthrombosis ye-uterine spiral arteries noma i-villus, okuholela ekufakweni kahle kwe-placental noma ngisho ne-infarction, njenge-Preeclampsia. , i-placenta abruption, i-placental infarction, i-disseminated intravascular coagulation (DIC), imingcele yokukhula kombungu, ukuphuphuma kwesisu okuphindaphindiwe, ukubeletha nokubeletha ngaphambi kwesikhathi, njll., kungaholela ekufeni komama kanye nokubeletha ezimweni ezimbi kakhulu.