Patterns of coagulation profiles observed in different trimesters of pregnancy


  • Joyce K. Olufemi-Aworinde Department of Haematology, Ladoke Akintola University of Technology Ogbomoso, Oyo State, Nigeria
  • Oladapo W. Aworanti Department of Haematology, University College Hospital, Ibadan, Oyo State, Nigeria
  • Samson A. Ojedokun Department of Chemical Pathology, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, Nigeria
  • Ibukun O. Akinbola Department of Haematology, Ladoke Akintola University of Technology Ogbomoso, Oyo State, Nigeria
  • Mobolaji Agunbiade-Olu Department of Haematology, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, Nigeria
  • Abraham I. Akinbola Department of Haematology, Ladoke Akintola University of Technology Ogbomoso, Oyo State, Nigeria



Natural coagulation inhibitor, Southwest, Nigeria, Pregnancy


Background: The risk of venous thromboembolic events (VTE) is high during pregnancy due to both physiologic changes in pregnancy and the impact of inherited and acquired thrombophilia. Protein S (PS), Protein C (PC) and Antithrombin III (ATIII) deficiencies have been found in some pregnant women with recurrent miscarriages and sudden maternal death. This study aimed to determine the changes in the level of plasma protein C, protein S and antithrombin III levels, its correlation with normal pregnancy.

Methods: The study was a comparative cross-sectional study conducted among seventy-five normal pregnant women who were selected using a simple random sampling technique with seventy-five age-matched healthy nonpregnant women. Blood samples were collected for analysis of protein C, protein S and antithrombin III using the enzyme-linked immunosorbent assay method. A semi-structured questionnaire was used as the survey instrument and Statistical analysis of data was done using SPSS version 24.

Results: The mean ages of the respondents were 32.6±4.6 and 34.5±6.9 years for the subjects and controls respectively. Natural coagulation inhibitors (NCI) show a gradual decrease across the trimesters of pregnancy. There was a statistical significance in the level of antithrombin III and protein S in the first trimester, p<0.05. When compared with the control of protein S of 4.78±0.65 ng/ml and antithrombin III of 554.16±54.65 ng/mL respectively.

Conclusions: It was demonstrated that there was an accompanying reduction of NCI across the trimester compared with the controls. Antithrombin III and protein S have a significant relationship with the gestation periods. Antithrombin III decreased as pregnancy advanced while protein S decreased significantly from the first trimester to the second trimester and was maintained at that level throughout the pregnancy.


Hoffbrand AV PAHM. Essential Heamatology. 6th Ed. Wiley-blackwell; 2011:345-380,413-423.

Battinelli EM, Marshall A, Connors JM. The role of thrombophilia in pregnancy. Thrombosis. 2013;2013:1-9.

Olutayo IM, Ajayi I. Haemostatic changes during pregnancy and puerperium in kano, north-western Nigeria. J Hematol Thromb Dis. 2015;03(05).

Victor Hoffbrand A, Catovsky D, Edward GD. Tuddenham ARG. Postgraduate Haematology. 6th ed. Wiley-blackwell;2011:746-928.

Sibai BM, How HY, Stella CL. Thrombophilia in pregnancy: Whom to screen, when to treat. Obg Manag. 2007;19(1):50-64.

Kaushanky K, Lichtman MA, Beutler E, Thomas J. Kipps, Uri Seligsohn JTP. Williams Haematology. 8th ed. McGraw-Hill; 2010:1721-2219.

Nwagha UT, Nwagha UI, Ibegbulam OG, Ocheni S, Okpala I. Increased prevalence of activated protein c resistance during pregnancy may implicate venous thrombo embolic disorders as a common cause of maternal mortality in Nigeria. J Bas Clin Reproduct Sci. 2012;1(1):19-24.

Walker ID, Infirmary R. Thrombophilia in pregnancy. J Clin Pathol. 2000;53(8):573-80.

Dawood F. Pregnancy and Thrombophilia. J Blood Disord Transfus. 2013;4(5):1-11.

Avwioro GO. Prothrombin time and activated partial thromboplastin time in pregnant women in southern Nigeria. J Appl Pharm Sci. 2013;3(April):179-81.

Babker AM, Gameel FE. Molecular characterization of prothrombin G20210A gene mutations In pregnant Sudanese women with spontaneous recurrent abortions. Rawal Med J. 2015;40(2):207-9.

Demir C, Dilek I. Natural coagulation inhibitors and active protein c resistance in preeclampsia. Clinics. 2010;65(11):1119-22.

Markoff A, Bogdanova N, Samama MM. Hereditary thrombophilic risk factors for recurrent pregnancy loss. Hereditary Genetics. 2012;1:2161-1041.

Katz D, Beilin Y. Disorders of coagulation in pregnancy. Br J Anaesth. 2015;115(suppl 2):75-88.

Okwesili A, Ibrahim K, Nnadi DC, Barnabas B. Fibrinogen levels among pregnant women of african descent in sokoto north Western Nigeria. Front Biomed Sci. 2016;1(September):7–11.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Ind J Psychol Medi. 2013;35(2):121-6.

Oladosu-olayiwola O, Olawumi H, Babatunde A, Ijaiya M. Fibrinolytic proteins of normal pregnancy and pre-eclamptic patients in North West Nigeria. Afr Health Sci. 2011;18(3):576-83.

Ronke O. Socio economic Characteristics of Residents of Multihabited Houses in Ogbomoso, South West, Nigeria. Glob J Human-Soci Sci Res. 2016;16(6):1-9.

Imoru Momodu FIB. Protein c and Antithrombin III Activities in Healthy Nigerian Women. Inter J Haematol Res. 2015;1(1):20-3.

Domenico Prisco, Gabriele Cuiti MF. Hemostatic changes in normal pregnancy. Haematol Repor. 2005;1(10):1-5.




How to Cite

Olufemi-Aworinde, J. K., Aworanti, O. W., Ojedokun, S. A., Akinbola, I. O., Agunbiade-Olu, M., & Akinbola, A. I. (2023). Patterns of coagulation profiles observed in different trimesters of pregnancy. International Journal of Research in Medical Sciences, 11(11), 4014–4019.



Original Research Articles