A Clinical Study Of Thrombelastograph In Thrombocytopenia During Pregnancy

Objective: This study was designed to explore the values of Thromboelastography (Thrombelastography, TEG) in blood coagulation function of pregnant women with thrombocytopenia in pregnancy, and its prediction value in obstetric hemorrhage.Methods: All the cases in this study were divided into 2 groups as below: control group including 70 cases of normal pregnant women; thrombocytopenia group including 34 cases of pregnant women, who were divided into 3 groups according to platelet count on admission: Group A with PLT between 80×109 / L and 99×109 / L (n = 14), Group B with PLT between 50×109 / L and 79×109 / L (n = 17), and Group C with PLT below 50×109 / L (n = 3). TEG test, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet count (PLT) were dectected respectively to understand changes in blood coagulation.①The quantitative indicators of 3 thrombocytopenia groups were compared with that of control group: TEG R time, K time, a angle, MA value, CI value to analyse the differences of platelet aggregation and relevance between MA value and the degrees of thrombocytopenia.②The differences of PT, APTT, Fg, TT values between 3 thrombocytopenia groups and control group, and relevance between PT, APTT, TT and the degrees of thrombocytopenia were analyzed.③The volumes of bleeding in labor and postpartum hemorrhage of different patterns of delivery in 4 groups were compared.Results: TEG results of control group showed hypercoagulability. No significant differences between thrombocytopenia group A group, B group and control group of the parameters were found(P> 0.05). Comparison between C group, control group, A group and B group : K value was found significantly prolonged; MA and CI was revealed significantly shortened(P <0.05). There was no significant difference of PT, APTT, Fg, TT values between control group and thrombocytopenia groups (P> 0.05). There was no significant correlation between the PLT value and PT, APTT, TT values of pregnant women; correlation coefficient (r) were r = 0.085, r = -0.070, r = 0.050. There was a weak correlation between TEG MA values and the PLT value in pregnant women; correlation coefficient (r) was r =0.198, P = 0.044(< 0.05); thrombocytopenia postpartum blood loss in each group no significant difference, P> 0.05. Conclusion:①TEG results of normal pregnant women showed hypercoagulability, consistent with the changes of hematological system during late trimester of pregnancy.②When the platelet counts were above or equal to 50×109 / L, platelet aggregation was normal and the coagulation status remained hypercoagulable. When the platelet counts were below 50×109 / L, the platelet aggregation would be decreased and the hypercoagulability of third trimester coagulation was reduced.③When platelet counts were between 80 and 99×109 / L, without clinical bleeding, postpartum bleeding risk is not higher than normal pregnant women. When platelet counts were between 50 and 79×109 / L, with no clinical bleeding, preoperative or intraoperative platelet transfusion would be reasonable during cesarean sections according to comprehensive analysis of the condition and test results of thromboelastography, and the risk of postpartum hemorrhage was not higher than normal pregnant women. When platelet counts were below 50×109 / L, platelet transfusion would be reasonable during cesarean sections according to comprehensive analysis of the condition and test results of thromboelastography, and the risk of postpartum hemorrhage was not higher than normal pregnant women.④TEG could be used as a useful indicator for coagulation status of thrombocytopenia in pregnancy pregnant.