Thromboelastography In Patients With Combined Thrombocytopenia In Pregnancy Monitoring Study Of Perinatal Coagulation Function

Objective:By comparing the results of Thromboelastogram(TEG)and traditional coagulation indexes in pregnant women with thrombocytopenia and normal pregnant women in late pregnancy,24 hours before and 24 hours after termination of pregnancy,the coagulation function of the patients was assessed as a whole,and the timing and mode of termination of pregnancy and the treatment of which blood components to be transfused were guided.Methods:Pregnant women who had outpatient obstetric checkups and inpatient deliveries in a hospital from December 2021 to December 2022 were selected to undergo routine blood tests at late gestation(≥28 weeks)and were grouped according to platelet count(Platelet,PLT),with pregnant women with PLT<100×10~9/L as the experimental group and those with normal PLT as the control group.In both groups,routine blood tests,thromboelastography and traditional coagulation indexes were performed in late pregnancy,within 24 hours before termination of pregnancy and within 24 hours after termination of pregnancy,and the results of these tests were counted and pregnancy outcomes were tracked,and statistical studies were performed using SPSS 25.0 software.Results:1.Comparison of general data Comparing age,gestational week,number of pregnancies and adverse pregnancy outcomes between 30 cases in the experimental group and 30 cases in the control group,there were no significant differences by statistical analysis(P>0.05).2.In the control group,the TEG test suggested a hypercoagulable state,and the R and K values shortened and the Angel angle and MA values increased with increasing weeks of gestation.3.Among the traditional coagulation indexes,there was no statistical difference in the APTT data between the two groups at three time points in the experimental group(P>0.05),and no statistical difference in the data at late pregnancy and 24 h before termination in the comparison between the experimental and control groups(P>0.05);there was no statistical difference in the PT data between the two groups at three time points in the experimental group(P>0.05);there was no statistical difference in the TT data between the two groups at three time points in the experimental and control groups(P>0.05);there was no statistical difference in the FIB data between the two groups at three time points in the experimental and control groups and at the same time point between the groups.There was no statistical difference between the data of two comparisons at three time points in the experimental group and the control group(P>0.05);there was no statistical difference between the data of two comparisons at three time points in the experimental group and the control group at the same time point between groups for FIB(P>0.05).4.The TEG parameters K value,Angel angle,and MA value were statistically different at the same time point when comparing the experimental group to the control group group(P<0.05).Among them,the differences in MA values were statistically significant(P<0.05)in the experimental group when comparing late gestation with 24 h before termination and 24 h before termination with 24 h after termination;the differences in CI values were statistically significant(P<0.05)in the two comparisons between the experimental and control groups at three time points within the groups.5.The TEG test in the experimental group was hypercoagulable in late pregnancy and 24h before termination,with prolonged R and K values and reduced Angel angle,MA and CI compared to the control group in the same period,a manifestation that continued until 24 hours after termination of pregnancy.6.K value,Angel angle,MA value,and CI value in TEG were correlated with PLT;among them,Angel angle,MA value,and CI value were positively correlated with PLT,and K value was negatively correlated with PLT.r value was not correlated with PLT.Conclusion:1.The TEG test in normal pregnant women in late pregnancy is hypercoagulable.2.TEG is superior to traditional coagulation indicators in reflecting the coagulation status of thrombocytopenic pregnant women.3.The TEG test in thrombocytopenic pregnant women had blood in a hypercoagulable state in late pregnancy and did not show significant hypercoagulability compared to normal pregnant women.4.TEG can be a useful indicator to monitor the coagulation status of thrombocytopenic pregnant women.5.Prophylactic platelet transfusion guided by TEG testing in pregnant women with PLT less than 50×10~9/L may reduce the incidence of adverse pregnancy outcomes such as postpartum hemorrhage.