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Mode of Delivery Does Not Influence Postpartum Hypercoagulability Measured by Thrombin Generation or
Boriana Guimicheva1,2, Lara N Roberts1, Jignesh P Patel1,3
1Department of Haematological Medicine, King's Thrombosis Centre, King's College Hospital NHS Foundation Trust, London, United Kingdom.
TH Open : Companion Journal to Thrombosis and Haemostasis
|January 10, 2020
Summary
Mode of delivery did not significantly alter postpartum hypercoagulability in high-risk women, as measured by thromboelastometry (TEM) and thrombin generation (TG). Both vaginal delivery and caesarean section showed similar hypercoagulability patterns post-birth.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Thrombosis Research
Background:
- Venous thromboembolism (VTE) is a leading cause of maternal mortality, with elevated risk postpartum.
- Mode of delivery, particularly emergency caesarean section (CS), significantly impacts VTE risk.
- Thromboprophylaxis is crucial for mitigating VTE in high-risk pregnancies.
Purpose of the Study:
- To evaluate the influence of delivery mode on maternal hypercoagulability.
- To assess hypercoagulability using thromboelastometry (TEM) and thrombin generation (TG) assays.
- To investigate postpartum hypercoagulability in women with VTE risk factors.
Main Methods:
- Blood samples collected from 99 high-VTE risk pregnant women at five time points (pre-delivery to 6 weeks postpartum).
- Analysis of thromboelastometry (TEM) and thrombin generation (TG) parameters.
- Statistical comparison using multiple linear regression and paired t-tests.
Main Results:
- Both vaginal delivery (VD) and CS groups exhibited postpartum hypercoagulability (T2 vs. T1), resolving by 6 weeks postpartum (T5).
- Minimal differences in TEM and TG were observed between VD and CS groups.
- The VD group showed a shorter clot formation time and higher maximum clot firmness at T2.
Conclusions:
- Pregnancy and delivery induce transient hypercoagulability, measurable by TEM and TG.
- Postpartum hypercoagulability patterns are similar between vaginal delivery and caesarean section in women with VTE risk factors.
- Further research is needed to understand labor's specific impact on coagulation markers without thromboprophylaxis.
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