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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
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Assessing maternal clotting function with novel global coagulation assays: A prospective pilot study
David O'Keefe1,2, Hui Yin Lim3,4, Johnathan Tham1,2
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic., Australia.
International Journal of Laboratory Hematology
|November 11, 2020
Summary
Global coagulation assays (GCAs) reliably detect pregnancy-related hypercoagulability. Thromboelastography (TEG) shows correlation with obesity, potentially aiding venous thromboembolism (VTE) risk assessment in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Thrombosis Research
Background:
- Pregnancy and the puerperium significantly increase women's risk of venous thromboembolism (VTE).
- Conventional coagulation assays offer limited insight into the complex hemostatic changes during pregnancy.
- Global coagulation assays (GCAs) provide a more comprehensive assessment of coagulability.
Purpose of the Study:
- To evaluate the ability of global coagulation assays (GCAs) to analyze coagulability in pregnant women.
- To assess the correlation between GCAs and varying venous thromboembolism (VTE) risk profiles in pregnancy.
- To investigate the utility of GCAs in identifying hypercoagulable states during pregnancy.
Main Methods:
- Blood samples were collected from 60 women undergoing term elective cesarean delivery before delivery.
- Samples were analyzed using conventional and novel coagulation tests, including thromboelastography (TEG), calibrated automated thrombogram (CAT), and overall haemostatic potential (OHP) assays.
- Data from 47 healthy nonpregnant women served as controls.
Main Results:
- Pregnant women exhibited hypercoagulability across most GCA parameters compared to nonpregnant controls.
- Increased clot strength (maximum amplitude on TEG) and enhanced thrombin and fibrin generation were observed in pregnant individuals.
- Pregnant women with a booking BMI ≥ 30 kg/m² showed significantly higher maximum amplitude on TEG compared to those with normal BMI.
Conclusions:
- Global coagulation assays (GCAs) effectively detect the physiological hypercoagulability associated with pregnancy.
- Thromboelastography (TEG) demonstrates a notable correlation with obesity in the pregnant population.
- GCAs may serve as valuable adjuncts to existing risk factor-based criteria for guiding VTE thromboprophylaxis during pregnancy and the puerperium.
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