The Role Of Thromboelastography In Patients With Hypertensive Disorders Of Pregnancy

ObjectiveThe purpose of this study was to understand the value of thromboelastography(TEG)in monitoring coagulation function status in patients with hypertensive disorders of pregnancy;to investigate the relationship between its index changes and coagulation function in patients with hypertensive disorders of pregnancy;and to analyze the differences between the parameters of thromboelastography and routine coagulation function indicators;aiming to provide new insights into early prevention and treatment of hypertensive disorders of pregnancy.MethodsThe case-control study was carried out from August 2017 to December 2019,84 patients diagnosed with hypertensive disorders of pregnancy were enrolled in the second affiliated hospital of Guangzhou Medical University.There were 25 cases of gestational hypertension,31 cases of preeclampsia and 28 cases of severe preeclampsia.97 normal pregnant women who matched the age and gestational age at the same period were selected as the control group.Blood was taken from the median cubital venous of the two groups of subjects for blood routine,five items of blood coagulation and thrombus elasticity examination.(1)The clinical data between the case group and the control group were compared(2)The differences of routine coagulation function indexes between the case group and the control group were compared(3)The differences of TEG parameters R time,K time,α angle,maximum clot strength MA value and coagulation state index(CI)between the case group and the control group were compared.(4)The correlation between the parameters of TEG and routine coagulation function indexes PT,APTT,Fib,PLT in the case group and the control group were compared(5)The differences of the parameters of TEG and routine coagulation function indexes in the case group with different severity of HDP were compared.Results(1)The APTT and PT time of the case group was shorter than that of the control group,while the PLT value and Fib value of the case group showed increase when compared with the control group.(P< 0.05)(2)Compared with the TEG parameters of the control group,the R-time and K-time of the TEG parameter value in the case group decreased significantly,and the α angle,MA value,and CI value all showed an upward trend,the difference was statistically significant.(P<0.05)(3)The correlation between the TEG parameters and the routine coagulation function indexes(PT,APTT,Fib,PLT)in the case group and the control group:(3)-1 The R time of the case group and the control group were positively correlated with APTT and PT(P<0.05),but there was no correlation with PLT or Fib;(3)-2 The K time of the case group and the control group were positively correlated with Fib(P<0.05),but there was no correlation with APTT,PT,PLT;(3)-3 The α angle of the case group and the control group were positively correlated with Fib(P<0.05),but there was no correlation with APTT,PT,and PLT;(3)-4 The MA value of the case group and the control group were positively correlated with PLT(P<0.05),but showed no correlation with APTT,PT,Fib;(3)-5 CI values of case group and control group were positively correlated with PLT and Fib(P<0.05),but no correlation with APTT,PT was observed;(4)In the case group,the R time and K time in the gestational hypertension group,preeclampsia group and severe preeclampsia group showed a downward trend(P< 0.05),and the α angle and MA value presented an upward trend(P< 0.05),there was no statistically significant difference between the results of routine coagulation function indexes and PLT values.ConclusionThis study suggests that patients with hypertensive disorders of pregnancy are more likely to suffer from hypercoagulability than normal pregnancy women,and thrombus elasticity parameter values correlate with the corresponding routine coagulation function indexes.TEG has some advantages over routine coagulation function in detecting the coagulation state of patients with HDP,it can respond to the coagulation state more comprehensively,but it cannot replace routine coagulation function completely.The combination of the two methods can monitor the coagulation function more accurately and provide more valuable basis for the diagnosis and treatment of HDP patients.