title: Thrombelastography changes in pre-eclampsia and eclampsia.
abstract: We have measured platelet count, bleeding time and thrombelastography (TEG) variables and the correlation between these variables in 49 pregnant patients presenting with pre-eclampsia or eclampsia. Eighteen patients (37%) had a platelet count < or = 150 x 10(9) litre-1 and seven (14%) had a platelet count < or = 100 x 10(9) litre-1. Bleeding time was prolonged > 9.5 min in 13 (27%) patients and the TEG was abnormal in four (8%). The TEG variables, k time and maximum amplitude (MA) had a strong correlation with platelet count (k time-platelet count < or = 150 x 10(9) litre-1, r = -0.68, P = 0.003, platelet count < or = 100 x 10(9) litre-1, r = -0.84, P = 0.02; MA--platelet count < or = 150 x 10(9) litre-1, r = 0.72, P = 0.001, platelet count < or = 100 x 10(9) litre-1, r = 0.78, P = 0.04). There was no correlation between bleeding time and thrombocytopenia (platelet count < or = 150 x 10(9) litre-1, r = -0.18, ns; platelet count < or = 100 x 10(9) litre-1, r = 0.09, ns). There was no correlation between bleeding time and any measured TEG variable. Of the 10 (20%) patients with an adequate platelet count (> 100 x 10(9) litre-1) but prolonged bleeding time, the TEG was normal, suggesting adequate haemostasis. An MA of 53 mm, which is the lower limit for normal pregnancy, correlated with a platelet count of 54 x 10(9) litre-1 (95% confidence limits 40-75 x 10(9) litre-1). Although the number of patients with severe thrombocytopenia was small, a platelet count of 75 x 10(9) litre-1 should be associated with adequate haemostasis.
authors.affiliation: Department of Anaesthetics, University of Natal, Durban, South Africa.
authors.forename: C E
authors.initials: CE
authors.lastname: Orlikowski
authors.forename: D A
authors.initials: DA
authors.lastname: Rocke
authors.forename: W B
authors.initials: WB
authors.lastname: Murray
authors.forename: E
authors.initials: E
authors.lastname: Gouws
authors.forename: J
authors.initials: J
authors.lastname: Moodley
authors.forename: D G
authors.initials: DG
authors.lastname: Kenoyer
authors.forename: S
authors.initials: S
authors.lastname: Byrne
mesh_terms: D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D001760:Bleeding Time; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000209:etiology*; D000075202:Contraindications; D004461:Eclampsia / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood / Q000150:complications; D011247:Pregnancy; D013916:Thrombelastography