Changes in thromboelastography parameters in pregnancy, labor, and the immediate postpartum period. Issue 3 (September 2016)

• Record Type: Journal Article
• Authors: Shreeve, Norman E.; Barry, John A.; Deutsch, Leah R.; Gomez, Keith; Kadir, Rezan A.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 134:Issue 3(2016:Sep.)
• Page Start: 290
• Page End: 293
• Publication Date: 2016-09
• Subjects: Clotting -- Labor -- Pregnancy -- Thromboelastography; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2016.03.010
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To demonstrate changes in clot mechanics during pregnancy, and to determine the effect that delivery has on immediate postpartum thromboelastography parameters. Methods: In an observational cross‐sectional/longitudinal study, thromboelastography was performed on whole blood aliquots obtained from women carrying singleton pregnancies attending a center in London, UK, between December 2013 and March 2014. Thromboelastography was repeated 6 hours after delivery among patients recruited in the third trimester or labor. Bleeding questionnaires were completed and routine clinical/demographic data obtained. Results: Overall, 112 women were included. The thromboelastography parameters were significantly correlated with length of pregnancy. From the third trimester to the postpartum period, there was a significant decrease in time until fibrin formation (R value; 5.8 vs 5.0 minutes, P = 0.036) and in time to reach a certain clot strength (amplitude of 20 mm; K value; 1.3 vs 1.1 minutes, P = 0.007). From established labor to after delivery, there was a significant increase in clot lysis at 60 minutes after the maximum amplitude of clot formation (LY60; 1.8% vs 3.1%, P = 0.001). Conclusion: The present study describes a novel finding regarding changes in clot mechanics in late pregnancy/puerperium and supports the concept of using thromboelastography as part of the routine assessments at delivery.