Coagulation status and complications of pregnancy.
BACKGROUND
There is much interest in the relationship between coagulation status and complications of pregnancy. The thrombelastograph (TEG) has been proposed as a useful, inexpensive tool to screen for patients with hypercoagulable states.


METHODS
We investigated 588 unselected pregnant women at booking, obtaining blood samples for TEG and thrombophilia investigation. Pregnancy outcome data was recorded.


RESULTS
We found significant correlations between TEG parameters and the Prothrombin time (PT) and Activated Partial Thromboplastin time (APTT) (p<0.01) and with plasma Antithrombin level (p<0.01). There was no correlation between TEG and other thrombophilic defects (protein C, protein S, Factor V Leiden mutation, Prothrombin G20210A mutation, MTHFR C677T mutation and Lupus Anticoagulant). There was a significant association of TEG parameters with mid-trimester loss (MTL) but not with other adverse pregnancy outcomes.


CONCLUSIONS
The correlation between TEG and PT, APTT and antithrombin level supports its value in providing a global measure of haemostasis. Coagulation status at booking is associated with increased risk of MTL but not with complications occurring later in pregnancy.
Miall
Fiona M
FM
University Hospitals of Leicester NHS Trust, United Kingdom.
Deol
Paramjeet S
PS
Barnes
Tim A
TA
Dampier
Karen
K
Watson
Christopher C
CC
Oppenheimer
Christina A
CA
Pasi
K John
KJ
Pavord
Sue R
SR
D000293:Adolescent; D000328:Adult; D001780:Blood Coagulation Tests / Q000295:instrumentation / Q000379:methods; D015897:Comorbidity; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012307:Risk Factors; D013916:Thrombelastography / Q000295:instrumentation / Q000592:standards; D019851:Thrombophilia / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014914:Whole Blood Coagulation Time