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Effect of amniotic fluid on coagulation and platelet function in pregnancy: an evaluation using thromboelastography
M J P Harnett1, D L Hepner, S Datta
1Staff Anaesthetist, Department of Anaesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. mharnett@partners.org
Anaesthesia
|October 19, 2005
Summary
Amniotic fluid embolism alters blood coagulation. This study shows amniotic fluid significantly impacts clotting time and platelet function in pregnant women, confirming coagulation changes are key to this obstetric complication.
Area of Science:
- Obstetrics
- Hematology
- Reproductive Medicine
Background:
- Amniotic fluid embolism (AFE) is a rare but devastating obstetric emergency.
- The precise mechanisms driving AFE pathogenesis remain unclear, with ongoing debate regarding the necessity of coagulopathy.
Purpose of the Study:
- To investigate the impact of amniotic fluid on coagulation and platelet function in pregnant women.
- To utilize thromboelastography (TEG) to analyze these effects.
Main Methods:
- Blood samples from pregnant women were treated with varying volumes of amniotic fluid (10-60 microl).
- Thromboelastography (TEG) was performed to assess coagulation variables.
- Platelet function was evaluated using the Reopro-TEG technique.
Main Results:
- A significant decrease in R time (clot formation time) was observed with the addition of 10 microl amniotic fluid.
- Platelet function, measured by Reopro-TEG, increased upon addition of 30 microl amniotic fluid.
- No evidence of fibrinolysis was detected in any of the tested samples.
Conclusions:
- The study supports the hypothesis that alterations in coagulation profiles are consistent findings in amniotic fluid embolism.
- These findings highlight the direct procoagulant and platelet-activating effects of amniotic fluid in vitro.