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Thromboelastography in term neonates.

Nicholas J Schott1, Stephen P Emery2, Courtney Garbee1

  • 1a Department of Anesthesiology , University of Pittsburgh , Pittsburgh , PA , USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|July 1, 2017
PubMed
Summary
This summary is machine-generated.

Thromboelastography (TEG) reveals no significant differences in coagulation parameters between term neonates delivered vaginally or by cesarean section. These findings establish normative neonatal TEG values, unaffected by delivery mode or labor, offering insights into fetal hemostasis.

Keywords:
Neonatal coagulationTEGthromboelastogramumbilical blood sampling

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Area of Science:

  • Neonatal Medicine
  • Hematology
  • Point-of-Care Testing

Background:

  • Thromboelastography (TEG) assesses coagulation dynamics, including fibrinolysis, in adults.
  • Normative TEG values for term neonates are currently undescribed, with limited studies on neonatal coagulation.
  • Existing neonatal TEG research suffers from small sample sizes and inconsistent methodologies.

Purpose of the Study:

  • To establish normative thromboelastography (TEG) data for healthy term neonates.
  • To investigate the impact of delivery mode (vaginal vs. cesarean) on neonatal TEG parameters.
  • To provide a baseline for understanding neonatal hemostasis and potential fetal coagulation insights.

Main Methods:

  • Umbilical venous blood samples were collected within 10 minutes of delivery from 100 healthy term neonates (50 vaginal, 50 cesarean).
  • Kaolin-activated thromboelastography (TEG) analysis was performed on citrated samples.
  • Cesarean delivery samples included both scheduled and unscheduled cases due to labor progression failure.

Main Results:

  • No statistically significant differences were observed in TEG parameters (R, K, α-angle, MA, LY30) between neonates delivered vaginally and those delivered by cesarean section.
  • Specific mean TEG values for vaginal delivery: R (5.41±1.34 min), K (1.62±0.75 min), α-angle (65.39±8.77°), MA (65.86±5.81 mm), LY30 (1.40±1.18%).
  • Specific mean TEG values for cesarean delivery: R (5.51±1.74 min), K (1.52±0.47 min), α-angle (64.15±4.61°), MA (64.15±4.61 mm), LY30 (2.44±3.51%).

Conclusions:

  • Thromboelastography (TEG) measurements in term neonates are consistent regardless of vaginal or cesarean delivery.
  • Labor progression does not appear to influence neonatal TEG parameters at term.
  • Established neonatal TEG values can inform understanding of fetal coagulation status at appropriate postconceptional ages.