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The role of thromboelastography and conventional coagulation tests in missed and recurrent spontaneous abortion: a
Yanqing Wu1, Min Li1, Yaqi Yan1
1Gynaecology Department, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background:
The contribution of coagulation parameters to pregnancy loss, especially the TEG, independent of embryonic chromosomal anomalies, is not well defined. This study investigated the association of coagulation profiles with Missed Abortion and Recurrent Spontaneous Abortion (RSA), accounting for chromosomal status.
Methods:
In this cross-sectional study, 648 participants were enrolled (398 missed abortion cases, 250 controls). From the 398 cases, 94 patients with recurrent spontaneous abortion (RSA) were selected and compared with healthy controls who had a normal current pregnancy and no history of adverse pregnancy outcomes (n = 233). Preoperative assessments included conventional coagulation tests, thromboelastography (TEG), and relevant clinical covariates (e.g., gravidity, parity, and history of adverse pregnancies). Postoperative embryonic chromosomal status was determined by CNV-seq. Multivariable logistic regression models adjusting for potential confounders were used to evaluate the associations.
Results:
Prolonged APTT and R-time were significantly associated with increased risks of missed abortion (APTT: OR = 1.14, 95% CI: 1.08-1.21; R-time: OR = 1.85, 95% CI: 1.38-2.49) and RSA (APTT: OR = 1.20, 95% CI: 1.09-1.33; R-time: OR = 1.81, 95% CI: 1.37-2.38). These associations persisted after stratifying by chromosomal normality in missed abortion. While, APTT and R-time values did not differ significantly in missed abortion between CNV-seq Negative and Positive groups.
Conclusion:
Prolonged APTT and R-time are independently associated with missed abortion and RSA, suggesting a role for impaired coagulation initiation in pregnancy loss etiology. These parameters may serve as useful clinical biomarkers for prognostic evaluation of pregnancy loss.
