Predictive Value Of FIB Combined With TEG K Value And αangle For HDP And Its Adverse Pregnancy Outcome

Objective: Fibrinogen(FIB)and thrombelastogram(TEG)parameters coagulation time(K)and angle of solidification(α)were analyzed to investigate the effect of FIB combined with K and α on the development of hypertensive disorders of pregnancy(HDP)and adverse pregnancy outcome.This study investigates the predictive effects of FIB combined with K and α on the development of Hypertensive Disorders of Pregnancy(HDP)and adverse pregnancy outcome,in order to provide a theoretical basis for early prediction,clinical intervention and avoidance of adverse pregnancy outcome in HDP.Methods:The clinical data of 218 pregnant women with confirmed HDP and TEG testing in our obstetrics department from January 2021 to January 2023 and normal pregnant women with TEG testing at the same gestational weeks in our hospital were collected retrospectively by the case browser.According to the inclusion and exclusion criteria,a total of 180 eligible cases were finally included in the study.According to the presence or absence of HDP and the degree of HDP,the subjects were divided into 4groups: Normal pregnancy group,Gestational Hypertension(GH)group,Preeclampsia(PE)group,and Severe Preeclampsia(SPE)group.Clinical data,age,gestational week,Body Mass Index(BMI),systolic blood pressure,diastolic blood pressure,history of HDP,family history of hypertension,gestational interval,FIB,K value,α angle and pregnancy outcomes of HDP pregnant women were collected.Pregnant women with HDP were divided into good pregnancy outcome group and adverse pregnancy outcome group according to pregnancy outcome.Results:1.There were significant differences in FIB level,K value level and α angle level among the four groups(P < 0.05).The level of FIB in GH group < Normal pregnancy group < PE group < SPE group;The level of K value in Normal pregnancy group > GH group > SPE group > PE group;The level of α Angle in Normal pregnancy group < GH group < PE group < SPE group.2.The correlation analysis of FIB,K value and α angle level with HDP disease degree showed that FIB and α Angle level were positively correlated with HDP disease degree(R=0.214,0.280,P= 0.023,0.003),and K value level was negatively correlated with HDP disease degree(R=-0.219,P=0.020).3.After multi-factor logistic regression analysis,the results showed that BMI,history of HDP,FIB,K value and α angle were the influencing factors of HDP(p < 0.05).BMI,HDP history,FIB,K value and α Angle were included in ROC curve.The results showed that the area under the curve of BMI prediction HDP was 0.720,the sensitivity was 54.90%,the specificity was 85.10%,and the best cut-off value was 30.42kg/㎡.The area under the curve predicted by FIB was 0.662,the sensitivity was 31.90%,the specificity was 97.00%,and the optimal cut-off value was 4.55g/L.The area under the curve predicted by α Angle was 0.692,the sensitivity was 75.20%,the specificity was53.70%,and the best truncation value was 65.35°.The combined FIB and α predicted the area under the curve was 0.753,the sensitivity was 76.10%,and the specificity was61.20%.The history of HDP and K value had no reference significance for the prediction of HDP(P > 0.05).4.After multifactorial logistic regression analysis,the results showed that K value and α angle were influential factors for adverse pregnancy outcome in HDP(P < 0.05).K value and α angle were included in ROC curve.The results showed that both K value andα angle could provide basis for predicting adverse pregnancy outcome(P<0.05).The area under the curve of K value predicting adverse pregnancy outcome in HDP patients was 0.611,the sensitivity was 83.60%,the specificity was 42.30%,and the optimal cut-off value was 1.95 min.The area under the curve of α Angle predicted adverse pregnancy outcome in HDP patients was 0.620,the sensitivity was 67.20%,the specificity was 59.60%,and the optimal cut-off value was 69.65°.The area under the curve was 0.649,the sensitivity was 78.70%,and the specificity was 48.10%.Conclusions:1.The levels of FIB and α angle were positively correlated with the degree of HDP disease,and the levels of K-value were negatively correlated with the degree of HDP disease.2.FIB and α angle can be used as early predictors of HDP,and the combined predictive value of the two is higher than the predictive value of each index alone,while BMI also has a strong predictive effect on HDP.3.K value and α angle can be used as predictors of adverse pregnancy outcome in patients with HDP,and the combined predictive value of the two is higher than the predictive value of each index alone.