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Screening for consumptive coagulopathy in preeclampsia
J Metz1, R Cincotta, M Francis
1Department of Hematology/Immunology, Royal Women's Hospital, Melbourne, Australia.
Insights
Screening for consumptive coagulopathy in preeclampsia (PE) can be efficiently done using a combination of platelet count and activated partial thromboplastin time (APTT) tests. This practical approach aids in early detection and management.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Clinical Pathology
Background:
- Preeclampsia (PE) is a serious pregnancy complication.
- Consumptive coagulopathy can arise in PE, necessitating effective screening.
- Identifying cost-effective diagnostic profiles is crucial for clinical practice.
Purpose of the Study:
- To determine a practical and cost-effective panel of laboratory tests for screening consumptive coagulopathy in preeclampsia.
- To evaluate the utility of various coagulation parameters in PE patients.
Main Methods:
- Retrospective analysis of coagulation test results (platelet count, PT, APTT, fibrinogen, D-dimers) in 100 preeclampsia patients.
- Patients were categorized based on hypertension and proteinuria status.
Main Results:
- Elevated D-dimers (34%) and thrombocytopenia (14%) were the most frequent abnormalities.
- Prolonged activated partial thromboplastin time (APTT) occurred in 12% of patients.
- A significant proportion of patients with elevated D-dimers alone did not show evidence of factor consumption.
Conclusions:
- A combination of platelet count and activated partial thromboplastin time (APTT) offers a practical and cost-effective screening strategy for consumptive coagulopathy in preeclampsia.
- This combination may streamline diagnostic workups and improve patient management.
Objective:
To identify a practical and cost-effective profile of tests to screen for consumptive coagulopathy in preeclampsia (PE).
Methods:
Retrospective analysis of the results of measurements of platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen and D-dimers in 100 patients presenting with PE uncomplicated by other disease or antepartum hemorrhage. Twenty-four patients had pregnancy-induced hypertension only, and 76 hypertension with proteinuria.
Results:
The incidence of abnormal tests on presentation was raised D-dimers 34%, thrombocytopenia 14%, prolonged APTT 12%, prolonged PT 3%, and low fibrinogen 2%. Prolonged APTT without thrombocytopenia occurred in 8% of patients. In 19 patients with elevation of D-dimers alone, only one showed evidence of consumption of coagulation factors on subsequent testing.
Conclusions:
A combination of platelet count and APTT is probably a practical and cost-effective combination to screen for consumptive coagulopathy in PE.