Українська English

ISSN 2522-9028 (Print)
ISSN 2522-9036 (Online)
DOI: https://doi.org/10.15407/fz

Fiziologichnyi Zhurnal

(English title: Physiological Journal)

is a scientific journal issued by the

Bogomoletz Institute of Physiology
National Academy of Sciences of Ukraine

Editor-in-chief: V.F. Sagach

The journal was founded in 1955 as
1955 – 1977 "Fiziolohichnyi zhurnal" (ISSN 0015 – 3311)
1978 – 1993 "Fiziologicheskii zhurnal" (ISSN 0201 – 8489)
1994 – 2016 "Fiziolohichnyi zhurnal" (ISSN 0201 – 8489)
2017 – "Fiziolohichnyi zhurnal" (ISSN 2522-9028)

Fiziol. Zh. 2026; 72(3): 73-81

Novel Laboratory Markers of Coagulation Disorders in Pregnant Women with Preeclampsia

R.F. Yeromenko1, O.M. Lytvynova1, H.L. Lytvynenko1

  1. National University of Pharmacy, Kharkiv
DOI: https://doi.org/10.15407/fz72.03.073


Abstract

The review addresses current challenges in the early diagnosis of coagulation disorders in pregnant women with preeclampsia, which is one of the most dangerous complications of gestation, characterized by systemic vascular, inflammatory, and hemostatic alterations. The study aimed to analyze modern laboratory markers of coagulation disorders in pregnant women with preeclampsia. A steady annual increase in the number of studies devoted to preeclampsia biomarkers and early risk stratification has been identified. It has been shown that an imbalance of angiogenic factors and the development of endothelial dysfunction represent key pathogenetic mechanisms and precede the clinical manifestation of the disease by several weeks. The most diagnostically and prognostically significant indicators of impaired angiogenesis and markers of coagulation cascade activation have been determined. The role of microRNAs in the regulation of placental function has been highlighted, along with the перспективність of studying epigenetic markers, cell-free placental DNA, alterations in metabolic pathways, and glycan structures of proteins as sensitive indicators of hypoxia, inflammation, and intercellular dysfunction. In pregnant women with severe preeclampsia, thromboelastography and rotational thromboelastometry have proven particularly informative, allowing comprehensive real-time assessment of the functional state of the hemostatic system. Comprehensive laboratory evaluation incorporating both conventional and novel markers is crucial for optimizing patient management and requires further standardization and scientific refinement.

Keywords: preeclampsia; laboratory biomarkers; hemostasis; coagulation disorders

Full text: (PDF, in Ukrainian)

References

  1. Beniuk V , Komar V , Kovaliuk T, Lastovetska L, Shcherba O, Shapovaliuk O. Anamnestic predictors of the risk of preeclampsia development: a contemporary view of the problem. Reprod Health Wom. 2025;3:104-12. [Ukrainian]. doi: 10.30841/2708-8731.3.2025.331554.
  2. Hong K, Park HJ, H Cha D. Clinical implications of placenta-derived angiogenic/anti-angiogenic biomarkers in pre-eclampsia. Biomark Med. 2021;15(7):523-36. doi: 10.2217/bmm-2020-0545.
  3. Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention. Int J Gynecol Obstet. 2019;145(Suppl 1):1- 33. doi: 10.1002/ijgo.12802.
  4. Ministry of Health of Ukraine. On approval of the Unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care «Hypertensive disorders during pregnancy». 2022. Order No. 151; 2022 Jan 24. https://www.dec.gov.ua/mtd/gipertenzyvnirozlady-y-vagitnyh/
  5. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gyne col. 2020;135(6):e237-e260. doi: 10.1097/AOG.000000 0000003891.
  6. Reddy M, Rolnik DL. Preventing pre-eclampsia and its complications. The continuous textbook of women's medicine series - Obstetrics module, health and risk in pregnancy and childbirth. V ol. 2. In: Hanson C, V ousden N, editors. London, UK: Glob Libr Women's Med. College; 2022. doi: 10.3843/GLOWM.416343
  7. Allard M, Grosch S, Jouret F, Masson V , Surinder T, Masset C. Prevention of preeclampsia and its complications. Rev Med Liege. 2024;79(5-6):448-54. змогу підвищити точність прогнозування та мінімізувати ризик гіпердіагностики або необґрунтованих втручань. Таким чином, подальше вивчення лабораторних маркерів при прееклампсії мають бути спрямовані на стандартизацію порогових значень, адаптацію алгоритмів до різних популяцій та інтеграцію цих показників у комплексні клінічні моделі. Можна з упевненістю стверджувати, що комплексне обстеження системи гемостазу, яке включає як стандартні, так і новітні лабораторні маркери, є ключовим для ефективного ведення вагітних з прееклампсією. Вивчення новітніх лабораторних маркерів при прееклампсії сприяє ранній діагностиці та стратифікації ризику, дає змогу виявити ризик розвитку прееклампсії ще до клінічної маніфестації, своєчасно змінити тактику ведення таких хворих та покращити материнські та перинатальні наслідки. The authors of this study confirm that the research and publication of the results were not associated with any conflicts regarding commercial or financial relations, relations with organizations and/or individuals who may have been related to the study, and interrelations of co-authors of the article. R.F. Yeromenko, O.M. Lytvynova, Н.L. Lytvynenko LATEST LABORATORY MARKERS OF COAGULATION DISORDERS IN PREGNANT WOMEN WITH PREECLAMPSIA National University of Pharmacy, Kharkiv; e-mail: rymma71@ukr.net The review addresses current challenges in the early diagnosis of coagulation disorders in pregnant women with preeclampsia, which is one of the most dangerous complications of gestation, characterized by systemic vascular, inflammatory, and hemostatic alterations. The study aimed to analyze modern laboratory markers of coagulation disorders in pregnant women with preeclampsia. A steady annual increase in the number of studies devoted to preeclampsia biomarkers and early risk stratification has been identified. It has been shown that an imbalance of angiogenic factors and the development Р.Ф. Єрьоменко, О.М. Литвинова, Г.Л. Литвиненко 80
  8. Yushchenko MI, Duka YuM. Modern view on the etiology and pathogenesis of preeclampsia as the main cause of perinatal losses. Zdorov Zhin. 2022;4(161):58-68. [Ukrainian]. doi: 10.15574/hw.2022.161.58.
  9. Jung E, Romero R, Yeo L, Gomez-Lopez N, Chaemsaithong P, Jaovisidha A, et al. The etiology of preeclampsia. Am J Obstet Gynecol. 2022;226(2S):S844-S66. doi: 10.1016/j. ajog.2021.11.1356.
  10. World Health Organization. 2025, Apr 4. Pre-eclampsia. Retrieved September 8, 2025. https://www.who.int/newsroom/fact-sheets/detail/pre-eclampsia
  11. Kelliher S, Maguire PB, Szklanna PB, Weiss L, Ewins K, O'Doherty R, et al. Pathophysiology of the venous thromboembolism risk in preeclampsia. Hamostaseologie. 2020;40(5):594-604. doi: 10.1055/a-1162-3905.
  12. Chermak VІ. Some features of the hemostasis system in pregnant women at risk of developing preeclampsia. Reproduct Health Woman. 2021;(6):61-5. doi: 10.30841/ 2708-8731.6.2021.244384.
  13. Mozgovaya EV, Peretyatko IS, Kornyushina EA, Androsova NE, Oparina TI, Antonova MI, et al. Clinical experience in the study of thrombodynamics in pregnant women at risk of developing preeclampsia and during its manifestation. J Obstetrics Women's Dis. 2024;73(5):44- 61. doi: 10.17816/JOWD634170.
  14. Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275-89. doi: 10.1038/ s41581-019-0119-6.
  15. Verlohren S, Brennecke SP, Galindo A, Karumanchi SA, Mirkovic LB, Schlembach D, et al. Clinical interpretation and implementation of the sFlt-1/PlGF ratio in the prediction, diagnosis and management of preeclampsia. Pregnan Hyperten. 2022;27:42-50. doi: 10.1016/j. preghy.2021.12.003.
  16. Drumheller BC, Stein DM, Moore LJ, Rizoli SB, Cohen MJ. Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review. J Trauma Acute Care Surg. 2019;86(4):710-21. doi: 10.1097/ TA.0000000000002206.
  17. Cerdeira AS, Kandzija N, Pargmae P, Cooke W, James T, Redman C, et al. Circulating soluble fms-like tyrosine kinase-1 is placentally derived in normal pregnancy: First in vivo evidence. Pregnan Hyperten. 2019;16:145-7. doi: 10.1016/j.preghy.2019.03.013.
  18. Zeisler H, Llurba E, Chantraine FJ, Vatish M, Staff AC, Sennström M, et al. Soluble fms-like tyrosine kinase-1 to placental growth factor ratio: ruling out pre-eclampsia for up to 4 weeks and value of retesting. Ultrasound Obstet Gynecol. 2019;53(3):367-75. doi: 10.1002/uog.19178.
  19. Dröge LA, Perschel FH, Stütz N, Gafron A, Frank L, Busjahn A, et al. Prediction of preeclampsia-related adverse outcomes with the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor)- ratio in the clinical routine: A real-world study. Hypertension. 2021;77(2):461-71. doi: 10.1161/ HYPERTENSIONAHA.120.15146.
  20. Kluivers ACM, Neuman RI, Saleh L, Russcher H, Brussé IA, Cornette JMJ, et al. Prerisk study: A randomized controlled trial evaluating a sFlt-1/PlGFbased calculator for preeclampsia hospitalization. Hypertension. 2025;82(5):827-38. doi: 10.1161/ HYPERTENSIONAHA.124.24386.
  21. Whitaker KM, Jones MA, Smith K, Catov J, Feghali M, Kline CE, et al. Study design and protocol of the multisite pregnancy 24/7 cohort study. Am J Epidemiol. 2024;193(3):415-25. doi: 10.1093/aje/kwad208.
  22. Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374(1):13-22. doi: 10.1056/NEJMoa1414838.
  23. Aminuddin NA, Sutan R, Mahdy ZA, Rahman RA, Nasuruddin DN. The feasibility of soluble Fms-like tyrosine kinase-1 (sFLT-1) and placental growth factor (PlGF) ratio biomarker in predicting preeclampsia and adverse pregnancy outcomes among medium to high risk mothers in Kuala Lumpur, Malaysia. PLoS One. 2022;17(3):e0265080. doi: 10.1371/journal. pone.0265080.
  24. Lim S, Li W, Kemper J, Nguyen A, Mol BW, Reddy M. Biomarkers and the prediction of adverse outcomes in preeclampsia: A systematic review and meta-analysis. Obstet Gynecol. 2021;137(1):72-81. doi: 10.1097/ AOG.0000000000004149.
  25. National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. NICE guideline [NG133]. London: NICE; 2021. https:// www.nice.org.uk/guidance/ng133
  26. Su S, Yang F, Zhong L, Pang L. Circulating noncoding RNAs as early predictive biomarkers in preeclampsia: a diagnostic meta-analysis. Reprod Biol Endocrinol. 2021;19(1):177. doi: 10.1186/s12958-021-00852-8.
  27. Lopes ACS, Macedo AA, Mendes FS, Costa IM, Dusse LMS, Alpoim PN. Changes in microRNA expression associated with preeclampsia: a systematic review. Braz J Med Biol Res. 2025;58:e13988. doi: 10.1590/1414-431x2025e13988.
  28. Baetens M, V an Gaever B, Deblaere S, De Koker A, Meuris L, Callewaert N, et al. Advancing diagnosis and early risk assessment of preeclampsia through noninvasive cell-free DNA methylation profiling. Clin Epigenet. 2024;16(1):182. doi: 10.1186/s13148-024-01798-5.
  29. Karapetian АО, Baev ОR, Sadekova АА, Krasnyi АМ, Sukhikh GT. Cell-free foetal DNA as a useful marker for preeclampsia prediction. Reprod Sci. 2021;28(5):1563-9. doi: 10.1007/s43032-021-00466-w.
  30. Poladych I.V . The effect of vitamin D3 deficiency and its correction on endothelial function in experimental preeclampsia. Fiziol Zh. 2025; 71(5): 47-55. doi: 10.15407/ fz71.05.047.
  31. Camacho-Carrasco A, Montenegro-Martínez J, Miranda-Guisado ML, Muñoz-Hernández R, Salsoso R, Fatela-Cantillo D, et al. Association of first-trimester maternal biomarkers with preeclampsia and related Новітні лабораторні маркери коагуляційних порушень у вагітних з прееклампсією 81
© National Academy of Sciences of Ukraine, Bogomoletz Institute of Physiology, 2014-2026.