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Hemostasis in Pre-Eclamptic Women and Their Offspring: Current Knowledge and Hemostasis Assessment with Viscoelastic

Christos-Georgios Kontovazainitis1, Dimitra Gialamprinou1, Theodoros Theodoridis2

  • 12nd Neonatal Department and Neonatal Intensive Care Unit (NICU), "Papageorgiou" University Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece.

Diagnostics (Basel, Switzerland)
|February 10, 2024
PubMed

Insights

Pre-eclampsia disrupts normal blood clotting, causing hypercoagulability. Viscoelastic tests like TEG/ROTEM show this excessive clotting, aiding in monitoring and predicting pre-eclampsia severity.

Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Perinatology

Background:

  • Pre-eclampsia (PE) is a serious pregnancy complication affecting maternal and neonatal health.
  • PE disrupts the normal hypercoagulable state of pregnancy, leading to abnormal blood clotting and fibrinolysis.
  • Conventional coagulation tests (CCTs) are insufficient for monitoring hemostatic changes in PE.

Purpose of the Study:

  • To review hemostasis in pre-eclampsia compared to normal pregnancy.
  • To explore maternal PE's impact on neonatal hemostasis.
  • To discuss the utility of viscoelastic tests (TEG/ROTEM) for assessing and monitoring PE-associated hemostatic alterations.

Main Methods:

  • This is a narrative review summarizing current knowledge.
  • Focuses on comparing hemostasis in PE versus healthy gestation.
  • Emphasizes the role of thromboelastography (TEG) and thromboelastometry (ROTEM) in PE.

Main Results:

  • TEG/ROTEM reveal excessive hypercoagulability in PE, correlating with disease severity.
  • PE is characterized by the formation of higher-stability fibrin clots compared to normal pregnancy.
  • TEG/ROTEM parameters show potential as monitoring and predictive markers for PE.

Conclusions:

  • Viscoelastic testing (TEG/ROTEM) offers a valuable tool for assessing PE-related hemostatic changes.
  • TEG/ROTEM can reflect PE severity and may aid in disease monitoring and prediction.
  • Further consideration of TEG/ROTEM in PE management is warranted due to CCT limitations.

Keywords:
blood coagulationhemostasisinfantnewbornpre-eclampsiapregnancythromboelastographythromboelastometry

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