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Platelet parameters in preeclampsia: comparing rotational thromboelastometry and platelet aggregometry with standard
A Malin1, G Garvey1, H McNamara1
1Tom Bryson Department of Anaesthesia, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, United Kingdom.
International Journal of Obstetric Anesthesia
|December 27, 2025
Summary
Point-of-care tests like thromboelastometry can help rule out low platelet counts in preeclampsia, aiding anesthesia decisions. However, their positive predictive ability needs more research for routine use.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Hematology
Background:
- Preeclampsia is a pregnancy disorder linked to coagulation issues.
- Standard platelet count tests have long turnaround times.
- Current guidelines use platelet count (<100,000/μL) to assess neuraxial anesthesia risk.
Purpose of the Study:
- To evaluate point-of-care (POC) rotational thromboelastometry and platelet aggregometry.
- To determine if POC tests can predict laboratory platelet counts in preeclampsia.
- To assess the utility of POC tests in managing anesthesia risk.
Main Methods:
- Prospective case-control study involving 71 preeclampsia patients and 57 controls.
- Compared thromboelastometry and platelet aggregometry parameters with laboratory tests.
- Performed serial testing in 55 preeclampsia patients.
Main Results:
- Four POC parameters (EXTEM A5, CEplatelet, PLTEM, ADP-induced aggregation) were lower in preeclampsia patients with low platelets.
- PLTEM showed a high negative predictive value (1.0) for platelet counts <100,000/μL.
- Serial testing reclassified anesthesia risk in two patients.
Conclusions:
- Thromboelastometry and aggregometry parameters may help rapidly rule out low platelet counts in preeclampsia.
- These POC tests could aid in assessing neuraxial anesthesia risk.
- Further research is needed due to limited positive predictive ability and sample size.
