Document Detail


Coagulation assessment by rotation thrombelastometry in normal pregnancy.
MedLine Citation:
PMID:  19350122     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We analysed changes in coagulation during normal pregnancy with a novel point-of-care device based on thrombelastometry (ROTEM). We compared the results obtained with those of standard coagulation tests in 104 patients: 20 non-pregnant women (controls) and 84 women in the first (T1, n = 17), second (T2, n = 9) and third (T3, n = 58) trimesters of pregnancy. We measured the clotting time (CT), the maximum clot firmness (MCF), the early clot amplitude at 5 and 15 minutes (CA(5), CA(15)) and the clot lysis index (CLI(30)) with four tests containing specific reagents. (a) The INTEM test involving ellagic acid activated the intrinsic pathway and (b) the EXTEM test using tissue factor triggered the extrinsic pathway; (c) The FIBTEM test based on a platelet inhibitor (cytochalasin D) evaluated the contribution of fibrinogen to clot formation and (d) the APTEM test was similar to the EXTEM but was based on inhibition in vitro of fibrinolysis by aprotinin. CT and CLI(30) were not significantly modified during pregnancy whereas MCF, CA(5) and CA(15) (INTEM, EXTEM, FIBTEM) increased significantly between the second and third trimesters (e.g. median [interquartile range]: MCF-FIBTEM, 13 [11-16] mm vs. 19 [17-23] mm, respectively, in controls and T3, p < 0.001). EXTEM values were not significantly different from those measured with APTEM. There were significant correlations between the results obtained with ROTEM and those from standard coagulation tests. ROTEM analysis showed a marked increase in coagulability during normal pregnancy. ROTEM values may serve as the basis for future studies in pregnant women.
Authors:
Cyril Huissoud; Nicolas Carrabin; Mehdi Benchaib; Oriane Fontaine; Albrice Levrat; Denis Massignon; Sandrine Touzet; René-Charles Rudigoz; Michel Berland
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  101     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-07     Completed Date:  2009-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  755-61     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Croix Rousse University Hospital, Lyon, Hospices civils de Lyon, France. cyril.huissoud@chu-lyon.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aprotinin / diagnostic use
Blood Coagulation*
Case-Control Studies
Cytochalasin D / diagnostic use
Ellagic Acid / diagnostic use
Female
Fibrinogen / metabolism
Fibrinolysis
Hemoglobins / metabolism
Humans
Partial Thromboplastin Time
Platelet Count
Point-of-Care Systems*
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Hematologic / blood,  diagnosis*
Pregnancy Trimesters / blood
Prospective Studies
Prothrombin Time
Reference Values
Rotation
Thrombelastography*
Thromboplastin / diagnostic use
Time Factors
Young Adult
Chemical
Reg. No./Substance:
0/Hemoglobins; 22144-77-0/Cytochalasin D; 476-66-4/Ellagic Acid; 9001-32-5/Fibrinogen; 9035-58-9/Thromboplastin; 9087-70-1/Aprotinin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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