[The use of thrombelastography in evaluation of coagulation in females with physiological or pathological gravidity].
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.


RESULTS
60 women in the 3rd trimester of physiological gravidity (group ZDRAVE) 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 ZDRAVE 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 ZDRAVE 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 degrees), 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 ZDRAVE was found. On the basis of the group ZDRAVE 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.
Polák
F
F
Klinika anesteziologie, resuscitace a intenzivní medicíny 1, LF UK a VFN, Praha. ferdinand.polak@vfn.cz
Lips
M
M
Bedrichová
H
H
Kríz
P
P
Parízek
A
A
D000328:Adult; D001777:Blood Coagulation; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D012016:Reference Values; D013916:Thrombelastography