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The quantitative estimation of soluble fibrin monomer complexes (SFMC) was applied to evaluate the state of hypercoagulability during pregnancy and delivery. Blood samples from 67 healthy primi and multiparae, 6 to 40 weeks pregnant, and from a group of 8 women in labour and after delivery of the placenta were examined. Fibrinogen and SFMC were precipitated from plasma by precipitation with beta-alanine. Gel filtration (4% agarose) of the redissolved precipitate resulted in a separation of SFMC and fibrinogen. This enabled a quantitative estimation of the SFMC concentration (with-in assay precision: coefficient of variation=8%). The % amount SFMC of the total fibrinogen content increased from 2.6 +/- 0.4 to 4.9 +/- 1.3% (mean and standard deviation) to week 40 of pregnancy. During delivery an additional statistically significant increase occurred. Chain analysis of SFMC showed a decreased amount of alpha-chain indicating plasmin activity. gamma-gamma-dimers as residuals of intermolecular covalent bonding were not observed. The quantitative estimation of SFMC during pregnancy and delivery demonstrates that a state of hypercoagulability during gestation can be evaluated by measuring the catabolic products of fibrinogen. This may lead to a differentiation from severe intravascular coagulation and to an early diagnosis of thromboembolic disease or consumption coagulopathy.
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