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Thromboelastography and Sonoclot analysis in the healthy parturient
1Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66160-7415.
Study Objective:
To compare values for two whole blood viscoelastic coagulation tests, thromboelastography (TEG) and Sonoclot analysis (Sonoclot R Coagulation Analyzer, Sienco, Inc., Morrison, CO), between healthy parturients and nonparturients.
Design:
Prospective study.
Setting:
University hospital.
Patients:
41 healthy, nonpregnant females and full-term nonlaboring and laboring parturients.
Interventions:
Blood samples for TEG and Sonoclot analysis were taken from all patients. TEG tracings were analyzed for reaction time (R), coagulation time (RK), the difference between RK and R (K), clot formation rate (alpha degree), and maximum amplitude (MA) values. Sonoclot tracings were analyzed for onset, rate increases, peak, and rate decreases values.
Measurements And Main Results:
All TEG values were significantly different between nonpregnant females and parturients (p < 0.05). Sonoclot analysis showed that the parturients had a significantly decreased onset and increased primary slope (rate increases) in comparison to the nonpregnant females (p < 0.05).
Conclusion:
The differences found in the parturients reflect a hypercoagulable state. If these tests are to be used in evaluating obstetric patients, the results should be compared with values obtained for healthy parturients, not healthy nonparturients.