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Thromboelastography in abruptio placentae.

D Moopanar¹, S Naidu, J Moodley

¹MRC/UN Pregnancy Hypertension Research Unit and Department of Obstetrics and Gynaecology, Faculty of Medicine University of Natal, Durban, South Africa.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology

|January 1, 1997

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Thromboelastographic (TEG) monitoring in abruptio placentae reveals its ability to detect major coagulation abnormalities, unlike standard tests. TEG is valuable for monitoring and treating coagulation defects in obstetric units.

Area of Science:

Obstetrics and Gynecology
Hematology
Critical Care Medicine

Background:

Abruptio placentae is a significant obstetric emergency associated with coagulation disorders.
Conventional coagulation tests may not fully capture the dynamic changes in hemostasis during this condition.

Purpose of the Study:

To document thromboelastographic (TEG) changes in patients with abruptio placentae.
To compare TEG findings with conventional coagulation tests for monitoring hemostasis.

Main Methods:

Prospective study of 30 patients diagnosed with abruptio placentae.
Coagulation parameters, including TEG, were assessed on admission, immediately postpartum, and at 4 and 24 hours post-delivery.

Main Results:

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Standard tests detected abnormalities, except for platelet counts normalizing within 24 hours.
Strong correlation observed between fibrinogen levels and TEG parameters (ma, k time; r=0.8).
Moderate correlation found between platelet count and TEG's ma parameter (r=0.6).
TEG identified 75% of major coagulation abnormalities and diagnosed hypercoagulability, an early sign of disseminated intravascular coagulation.

Conclusions:

Minor clotting profile abnormalities are clinically insignificant and often missed by TEG due to its holistic assessment.
TEG is a valuable tool for diagnosing hypercoagulability and monitoring significant coagulation defects in obstetric settings, especially when rapid results are needed.