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Changes in thromboelastography parameters in pregnancy, labor, and the immediate postpartum period
Author(s) -
Shreeve Norman E.,
Barry John A.,
Deutsch Leah R.,
Gomez Keith,
Kadir Rezan A.
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.03.010
Subject(s) - thromboelastography , medicine , pregnancy , obstetrics , observational study , postpartum period , anesthesia , coagulation , genetics , biology
Objective To demonstrate changes in clot mechanics during pregnancy, and to determine the effect that delivery has on immediate postpartum thromboelastography parameters. Methods In an observational cross‐sectional/longitudinal study, thromboelastography was performed on whole blood aliquots obtained from women carrying singleton pregnancies attending a center in London, UK, between December 2013 and March 2014. Thromboelastography was repeated 6 hours after delivery among patients recruited in the third trimester or labor. Bleeding questionnaires were completed and routine clinical/demographic data obtained. Results Overall, 112 women were included. The thromboelastography parameters were significantly correlated with length of pregnancy. From the third trimester to the postpartum period, there was a significant decrease in time until fibrin formation (R value; 5.8 vs 5.0 minutes, P = 0.036) and in time to reach a certain clot strength (amplitude of 20 mm; K value; 1.3 vs 1.1 minutes, P = 0.007). From established labor to after delivery, there was a significant increase in clot lysis at 60 minutes after the maximum amplitude of clot formation (LY60; 1.8% vs 3.1%, P = 0.001). Conclusion The present study describes a novel finding regarding changes in clot mechanics in late pregnancy/puerperium and supports the concept of using thromboelastography as part of the routine assessments at delivery.