title: Role of Thromboelastography Versus Coagulation Screen as a Safety Predictor in Pre-eclampsia/Eclampsia Patients Undergoing Lower-Segment Caesarean Section in Regional Anaesthesia.
abstract: OBJECTIVE
  In this study, we aimed to correlate thromboelastography (TEG) variables versus conventional coagulation profile in all patients presenting with pre-eclampsia/eclampsia and to see whether TEG would be helpful for evaluating coagulation in parturients before regional anaesthesia.
  
  
  METHODS
  This was a prospective study on 100 pre-eclampsia/eclampsia patients undergoing lower-segment caesarean section under regional anaesthesia. Two blood samples were collected. First sample was used for TEG measurement and second sample for laboratory tests. The following TEG data were obtained-reaction time, kinetic time, alpha angle, and maximum amplitude (MA). The following laboratory tests were obtained-haematology (haemoglobin, TLC, DLC, platelet count) and coagulation test [prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT)].
  
  
  RESULTS
  Out of 100 patients enrolled in the study, 80 (80 %) had a normal coagulation profile, while remaining 20 (20 %) had hypocoagulation profile. The results show that TEG parameters have a good correlation with conventional coagulation profile and also showed excellent independent predictive efficacy for prediction of hypocoagulation. PT, aPTT, and TT were directly proportional to R-time and K-time and inversely proportional to alpha angle (p < 0.001). Platelet count showed a strong positive correlation with MA (p < 0.001).
  
  
  CONCLUSIONS
  By giving a global picture of haemostasis, TEG can lead to improved decision-making about safety of using regional anaesthesia. Its fast feedback time makes it ideal for monitoring in a fast moving situation such as in obstetric emergency.
authors.affiliation: Department of Anesthesiology and Critical Care, T. S. Mishra Medical College and Hospital, Haleem Manor, Flat No.-401, 179/19, Baroodkhana, Golaganj, Lucknow, 226018 India.
authors.forename: Asrar
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: Monica
authors.initials: M
authors.lastname: Kohli
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Anesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India.
authors.forename: Megha
authors.initials: M
authors.lastname: Kohli
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: Jaishri
authors.initials: J
authors.lastname: Bogra
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: Haider
authors.initials: H
authors.lastname: Abbas
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: Rajni
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, India.
authors.forename: B B
authors.initials: BB
authors.lastname: Kushwaha
keywords: Coagulation; Regional anaesthesia; Thromboelastography