{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T06:13:41Z","timestamp":1696313621824},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,8,28]],"date-time":"2014-08-28T00:00:00Z","timestamp":1409184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2014,12]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>The aim of this study was to determine whether antenatal decline in antithrombin (AT<\/jats:styled-content>) activity occurs frequently and precedes the development of perinatal liver dysfunction in women with triplet pregnancies.<\/jats:p><\/jats:sec>Material and Methods<\/jats:title>A retrospective observational study was conducted on all women who gave birth to triplets at gestational week \u226522 at a single centre during a study period from J<\/jats:styled-content>anuary 2001 to M<\/jats:styled-content>arch 2013. The following eight blood parameters were monitored weekly during the last 5 weeks of pregnancy and postpartum: AT<\/jats:styled-content> activity, platelet count, fibrinogen, D<\/jats:styled-content>\u2010dimer, aspartate aminotransferase (AST<\/jats:styled-content>), lactate dehydrogenase (LDH<\/jats:styled-content>), uric acid and creatinine. Pregnancy\u2010induced AT<\/jats:styled-content> deficiency (PIATD<\/jats:styled-content>) and gestational thrombocytopenia were defined as antenatal AT<\/jats:styled-content> activity <70% of normal level and antenatal platelet count <150\u2009\u00d7\u2009109<\/jats:sup>\/L<\/jats:styled-content>, respectively. Liver dysfunction was defined as AST<\/jats:styled-content> >\u200940 IU<\/jats:styled-content>\/L. LDH<\/jats:styled-content> elevation was defined as LDH<\/jats:styled-content> >\u2009450 IU<\/jats:styled-content>\/L.<\/jats:p><\/jats:sec>Results<\/jats:title>Sixteen women were eligible for this study. All variables except LDH<\/jats:styled-content> exhibited significant changes antenatally: AT<\/jats:styled-content> activity, platelet count and fibrinogen decreased, while D<\/jats:styled-content>\u2010dimer, AST<\/jats:styled-content>, urate and creatinine increased. LDH<\/jats:styled-content> increased significantly postpartum. PIATD<\/jats:styled-content>, gestational thrombocytopenia, perinatal liver dysfunction, and LDH<\/jats:styled-content> elevation occurred in eight, seven, six, and eight women, respectively. Liver dysfunction was preceded by PIATD<\/jats:styled-content> alone in three, by both PIATD<\/jats:styled-content> and gestational thrombocytopenia in one and by gestational thrombocytopenia alone in none of the subjects. After delivery, laboratory abnormalities similar to HELLP<\/jats:styled-content> syndrome were seen in three women exclusively in the presence of PIATD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Reduced AT<\/jats:styled-content> activity was likely to precede perinatal liver dysfunction in women with triplets.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12470","type":"journal-article","created":{"date-parts":[[2014,8,28]],"date-time":"2014-08-28T06:21:24Z","timestamp":1409206884000},"page":"2177-2183","source":"Crossref","is-referenced-by-count":6,"title":["Liver dysfunction in triplet pregnancies: Relation to antenatal changes in antithrombin activity and platelet count"],"prefix":"10.1111","volume":"40","author":[{"given":"Ryutaro","family":"Nishida","sequence":"first","affiliation":[{"name":"Department of Obstetrics Hokkaido University Graduate School of Medicine Sapporo Hokkaido 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