Kathleen M Antony1, Roshanak Mansouri2, Melanie Arndt1, Shiu-Ki Rocky Hui3, Purviben Jariwala3, Virginia Moreland Mcmullen3, Jun Teruya3, Kjersti Aagaard1. 1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. 2. Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. 3. Division of Transfusion Medicine and Coagulation, Department of Pathology, Baylor College of Medicine, Houston, Texas.
Abstract
OBJECTIVE: The diagnosis of coagulopathy cannot always be performed at point of care. Thromboelastography (TEG) and the platelet-function analyzer (PFA-100), have emerged as reliable means for coagulation analysis. However, their reliable utility in pregnancy remains to be determined. We sought to establish reference values with concomitant determination of other known coagulation measures in nonlaboring gravidae in an effort to report the mean and variance of multiple testing modalities. STUDY DESIGN: Fifty-nine term, nonlaboring, pregnant women without comorbidities were enrolled, either at presentation for scheduled delivery or at presentation to triage for a non-labor-related indication. TEG, PFA-100, and complete coagulation measures of the overall hemostatic function (including prothrombin time, activated partial thromboplastin time, fibrinogen, protein C, protein S, von Willebrand factor antigen, ristocetin cofactor activity, and ADAMTS-13) were performed. Prior investigations of TEG and PFA-100 parameters in normal gravidae were reviewed, and pooled means and standard deviations (as a measure of variance) were calculated. RESULTS: TEG and PFA-100 parameters were significantly different among pregnant gravidae compared with nonpregnant reference ranges, and varied in association with other measures of the coagulation system. Our results and the pooled results reflect a hypercoagulable state. CONCLUSION: Our data suggest that TEG values are significantly different in term, nonlaboring, healthy gravidae compared with nonpregnant reference values. Pooled means and standard deviations shown here may be considered for reference. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: The diagnosis of coagulopathy cannot always be performed at point of care. Thromboelastography (TEG) and the platelet-function analyzer (PFA-100), have emerged as reliable means for coagulation analysis. However, their reliable utility in pregnancy remains to be determined. We sought to establish reference values with concomitant determination of other known coagulation measures in nonlaboring gravidae in an effort to report the mean and variance of multiple testing modalities. STUDY DESIGN: Fifty-nine term, nonlaboring, pregnant women without comorbidities were enrolled, either at presentation for scheduled delivery or at presentation to triage for a non-labor-related indication. TEG, PFA-100, and complete coagulation measures of the overall hemostatic function (including prothrombin time, activated partial thromboplastin time, fibrinogen, protein C, protein S, von Willebrand factor antigen, ristocetin cofactor activity, and ADAMTS-13) were performed. Prior investigations of TEG and PFA-100 parameters in normal gravidae were reviewed, and pooled means and standard deviations (as a measure of variance) were calculated. RESULTS: TEG and PFA-100 parameters were significantly different among pregnant gravidae compared with nonpregnant reference ranges, and varied in association with other measures of the coagulation system. Our results and the pooled results reflect a hypercoagulable state. CONCLUSION: Our data suggest that TEG values are significantly different in term, nonlaboring, healthy gravidae compared with nonpregnant reference values. Pooled means and standard deviations shown here may be considered for reference. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: S Alvarado-Ramos; V J Lara-Díaz; M R López-Gutiérrez; M E Torcida-González; J F Campos-Rodríguez Journal: Anesthesiol Res Pract Date: 2020-10-28