title: An assessment of the effects on coagulation of midtrimester and final-trimester amniotic fluid on whole blood by Thrombelastograph analysis.
abstract: The Thrombelastograph((R)) test (TEG; Haemoscope Corporation, Skokie, IL) was used to assess the effects of midtrimester and final-trimester amniotic fluid (AF) on whole blood coagulation. Different volumes of midtrimester and final-trimester AF were added to whole blood from nonpregnant volunteers in a series of TEG tests. The addition of both midtrimester and final-trimester AF resulted in significant decreases in reaction time (P < 0.001) and time from reaction to a fixed level of clot firmness (P < 0.05) and significant increases in angle (P < 0.05) and coagulation index (P < 0.05) values. This reflects accelerated clot initiation and propagation. There was no significant change in the maximal amplitude or % lysis at 30 and 60 min with the addition of either midtrimester or final-trimester AF. There was no significant difference between the effects of midtrimester and final-trimester AF on whole blood TEG. TEG may be an additional useful tool in the treatment of coagulopathy in AF embolism.
  
  
  CONCLUSIONS
  We used the Thrombelastograph((R)) test (Haemoscope Corporation, Skokie, IL) to assess the effects of midtrimester and final-trimester amniotic fluid (AF) on whole blood coagulation. Results demonstrate that AF accelerates clot initiation and propagation. The Thrombelastograph((R)) test may be useful in assessing coagulopathy in patients with AF embolism.
authors.affiliation: Departments of Anaesthesia and Obstetrics and Gynaecology, National University Hospital, Singapore.
authors.forename: E H
authors.initials: EH
authors.lastname: Liu
authors.forename: S
authors.initials: S
authors.lastname: Shailaja
authors.forename: S C
authors.initials: SC
authors.lastname: Koh
authors.forename: T L
authors.initials: TL
authors.lastname: Lee
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000502:physiology*; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000295:instrumentation; D004548:Elasticity; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D066298:In Vitro Techniques; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011263:Pregnancy Trimester, Third / Q000097:blood*