The Use of Thrombelastography in Evaluation of Coagulation
in Females with Physiological or Pathological Gravidity
1Polák F., 1Lipš M., 1Bedřichová H., 1Kříž P., 2Pařízek A.
1Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a VFN, Praha 2Gynekologicko–porodnická klinika 1. LF UK a VFN, Praha |
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Summary:
Background. During gravidity changes in coagulation develop, however different norms for pregnant
women and prevailing population are rarely used. Pathological gravidity can be accompanied with more
significant coagulopathies. Thrombelastography is more and more frequently used for evaluation of
coagulation parameters of pregnant women. The aim of the study was to compare thrombelastographic
coagulation parameters in females with physiological or pathological gravidity and with norms for
prevailing population.
Methods and Results. 60 women in the 3rd trimester of physiological gravidity (group ZDRAVÉ) and
50 women with pathological gravidity (women with preeclampsia or with a dead fetus, group PATOL)
were examined. Both groups were of the comparable age. Average values of studied parameters in the
group ZDRAVÉ were found at the level of “procoagulation” limits for prevailing population. In the group
PATOL, average values were even more “procoagulative”, however, differences to the ZDRAVÉ group
were nor significant: time r 4.7 (SD 1.7) vs. 4.4 (SD 2.0) p=0.461 (norm for prevailing population 4–8
min), time to 1.5 (0.5) vs. 1.3 (0.4) p=0.030 (norm 1–4 min), angle alpha 69.6 (5.5) vs. 71.0 (7.7) p=0.324
(norm 47–74°), maximal amplitude 71.3 (4.5) vs. 73.1 (4.7) p=0.079 (norm 55–73 mm), coagulation
index 2.7 (1.8) vs. 3.2 (1.8) p=0.219 (norm (–3)–(+3)). In the group PATOL higher variability than in the
group ZDRAVÉ was found. On the basis of the group ZDRAVÉ selection percentiles, new norms of
thrombelastographic coagulation parameters for pregnant women were elaborated.
Conclusions. Coagulation during pregnancy differs significantly from that of prevailing population.
That is why the new thrombelastographic norms for pregnant women are submitted. Coagulation
changes in pathological pregnancies are more difficult to anticipate than in healthy gestations.
Key words:
thrombelastography, pregnancy, coagulopathy, preeclampsia.
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