Winter Fetal Arrest Crisis: How Pre-Thrombotic State Becomes the “Invisible Killer” of Embryos?
Winter Fetal Arrest Crisis: How Pre-Thrombotic State Becomes the “Invisible Killer” of Embryos? I. Behind the scene of 60% of fetal arrests: the neglected prethrombotic state In the field of reproductive medicine, pre-thrombotic state (PTS) is becoming the number one risk factor for recurrent pregnancy loss. Recent multinational studies have shown that 62.8% of fetal terminations and biochemical pregnancies are directly related to maternal PTS, with the prevalence being 40% higher in winter than in other seasons. This tendency of hypercoagulability is like a time bomb that silently cuts off the embryo’s lifeline. Placental microthrombosis: maternal blood hypercoagulation leads to thrombosis of spiral arteries, blocking the oxygen and nutrient supply to the embryo.Trophoblastic dysfunction: Hyperfibrinogenemia (>4g/L) inhibits chorionic angiogenesis and reduces the depth of embryo attachment by 50%.Immune imbalance: Abnormally elevated platelet-activating factor (PAF) triggers maternal immune attack on the embryo.High truth in winter: low temperature triggers vasoconstriction, blood flow rate decreases by 30%, and uterine artery resistance index (RI) rises to 0.85 (normal <0.6), exacerbating placental underperfusion. II. the five warning signals and diagnostic criteria of the pre-thrombotic state Abnormal fatigue: normal hemoglobin but persistent tiredness (differentiated from anemia)Limb swelling: asymmetric lower extremity edema, morning stiffness of the fingersSkin changes: reticular bruising, recurrent mouth ulcers Testing Program risk threshold clinical significance D-dimer ≥0.5 mg/L Reflects excessive activation of the fibrinolytic system Protein S activity ≤60% 天Deficiency of natural anticoagulant substances antithrombin III ≤80% Core risk of thrombosis platelet aggregation rate ≥80%(ADPrevulsion) Significant increase in blood viscosity homocysteine (Cys), an amino acid ≥15 μmol/L Vascular Endothelial Injury Markers Diagnostic Criteria: Fulfillment of any 2 abnormalities is indicative of a pre-thrombotic state and intervention needs to be initiated. III.The Triple Risk of Winter: How Climate Exacerbates the Fertility Crisis For every 5°C drop in temperature, peripheral vascular resistance increases by 12%…
