Thromboelastography Applied in Diagnosing Normal and Complicated Pregnancies

During pregnancy, the coagulation system in women undergoes considerable changes to prevent bleeding. If the coagulation system in pregnant women is not functioning optimally, incidents such as bleeding and miscarriage are prone to occur; if the coagulation system in pregnant women is hyperfunctional, the risk of venous thrombosis is high.

At present, many indicators such as activated partial prothrombin time and prothrombin time are used to detect blood coagulation function in the body. Thromboelastography (TEG), as a currently accessible laboratory test, can reflect the dynamic changes in the coagulation process and has high application value in evaluating platelet function.

Hematologists at the Affiliated Hospital of Hubei Polytechnic University (Huangshi, China) collected samples for 156 pregnant women with normal pregnancy (NP) and 58 women with threatened abortion (TA), 13 with missed abortion (MAb), 25 with embryo arrest (EA), four with fetal death (FD), six with a history of abnormal pregnancy (HAP), and seven with antiphospholipid antibody syndrome (AA).

TEG was performed using a BVCA-I thromboelastometer. The parameters R, K, α-angle, MA, LY-30, G, and coagulation index (CI) were analyzed. Partial correlation analysis was used to analyze correlation between groups of data. LSD-t test and Dunnett's T3 test were used to analyze continuous variables. Ordinal categorical variables were compared using ordinal logistic regression analysis and estimate odds ratio of risk factors. A receiver operating characteristic (ROC) curve was constructed to detect the ability of TEG to recognize various parameters, and areas under the curve were compared using Delong's test for diagnosing pregnancy-related diseases.

The scientists reported that there was no correlation between the data of NP and TA, and NP and FD groups; MAb had a negative effect on the MA parameter in TEG; EA had a negative effect on the MA and G parameters; HAP had a negative effect on the CI parameter and a positive effect on the R parameter; AA had a negative effect on the CI parameter. The team found that TEG parameters were different between some patient groups and control groups. For example, the CI value of the TA group was decreased, and the ratio of the angle value lower than the upper limit of the normal reference value was higher than that of the NP group, indicating that the coagulation function is low, and there could be a problem of inadequate fibrin levels or function.

The authors concluded that TEG has a good clinical significance in the diagnosis of TA, MAb, EA, AA, and HAP. The study was published on April 24, 2022 in the Journal of Clinical Laboratory Analysis.

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