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Thromboelastometry: studying hemostatic profile in small for gestational age neonates-a pilot observational study
Rozeta Sokou1, Aikaterini Konstantinidi2, Charikleia Stefanaki2
1Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece. sokourozeta@yahoo.gr.
European Journal of Pediatrics
|February 2, 2019
Summary
Thromboelastometry (TEM) shows that small for gestational age (SGA) neonates have a fully functional coagulation system, similar to appropriate for gestational age (AGA) neonates, with no increased risk of bleeding or clotting.
Area of Science:
- Neonatal Medicine
- Hematology
- Pediatric Coagulation
Background:
- Limited data exists on the hemostatic status of small for gestational age (SGA) neonates.
- SGA neonates may experience coagulation issues due to factors like intrauterine hypoxia, hepatic dysfunction, polycythemia, and thrombocytopenia.
- Previous studies show laboratory differences but no significant clinical hemostatic alterations in SGA neonates.
Purpose of the Study:
- To evaluate the hemostatic profile of SGA neonates using thromboelastometry (TEM).
- To compare the coagulation status of SGA neonates with appropriate for gestational age (AGA) neonates.
Main Methods:
- An observational study involving 93 neonates (45 SGA, 48 AGA) in a Greek tertiary hospital.
- Thromboelastometry (TEM), specifically extrinsically activated TEM (ex-TEM) parameters, was used.
- Evaluated parameters included clotting time, clot formation time, angle, maximum clot firmness, lysis index, and platelet count.
Main Results:
- No statistically significant differences were observed in ex-TEM parameters between SGA and AGA neonates.
- No instances of hemorrhage or thrombosis were reported in the study population.
- TEM provided a comprehensive assessment of coagulation and fibrinolysis.
Conclusions:
- The coagulation system in SGA neonates appears to be fully functional compared to AGA neonates.
- TEM is a promising tool for assessing neonatal hemostasis and may serve as a future biomarker.
- Further large-scale studies are needed to validate these findings.
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