Baseline parameters for non-activated rotational thromboelastometry tests with and without heparinase in healthy pregnant women at term gestation - 13/11/21
, Da Wi Shin, B.E. a, Matthew Sison, B.S. b, Daniel Katz, M.D. bAbstract |
Objective |
To determine the normal values for non-activated thromboelastometry parameters among pregnant women.
Design |
Prospective, observational study.
Setting |
Tertiary care hospital.
Patients |
Non-laboring women at term gestation without history of bleeding or clotting disorder or anticoagulation use.
Interventions |
Venous blood samples were collected and ROTEM® was performed using NATEM and NaHEPTEM assays.
Measurements |
Reference ranges were derived by calculating 2.5 and 97.5 percentiles for the following parameters: clotting time (CT), clot formation time (CFT), amplitude at 10 (A10) and 20 min (A20), alpha angle, maximum clot firmness (MCF), and lysis index at 30 (LI30) and 60 min (LI60). The NATEM/NaHEPTEM CT ratio was calculated to determine the baseline ratio in term pregnant women.
Main results |
146 women were screened and 120 were enrolled. The median age was 34 years [31–36], median gestational age was 39.1 weeks [38.3–39.3], and median parity was 1 [0–2]. Median pre-delivery platelet and hematocrit levels were within the normal ranges. The reference ranges for NATEM parameters were: CT (232–759 (s)), CFT (69–243 (s)), alpha angle (50–77 (°)), A10 (44–69 (mm)), A20 (54–75 (mm)), MCF (57–77 (mm)), LI30 (100–100 (%)), LI60 (90–100 (%)). The reference ranges for NaHEPTEM parameters were: CT (224–717 (s)), CFT (66–210 (s)), alpha angle (53–77 (°)), A10 (44–67 (mm)), A20 (55–73 (mm)), MCF (58–74 (mm)), LI30 (99–100 (%)), LI60 (90–100 (%)). The NATEM to NaHEPTEM CT ratio reference range was 0.73–1.3.
Conclusions |
This study is the first to our knowledge to report reference ranges for non-activated ROTEM® tests with and without heparinase in non-laboring term pregnant women. These reference ranges may serve as a baseline comparison and may be useful for future research on anticoagulation management in pregnancy.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Non-activated thromboelastometry is a highly sensitive method for identifying coagulopathy. |
• | No study thus far has determined baseline reference ranges for term parturients using non-activated rotational thromboelastometry (ROTEM). |
• | This study provides reference ranges for 120 non-laboring, term pregnant women using non-activated ROTEM tests with and without heparinase (NATEM and NaHEPTEM). |
• | The establishment of baseline reference ranges for NATEM and NaHEPTEM may be useful for future research on anticoagulation management in pregnancy. |
Keywords : Coagulation, Pregnancy, Reference ranges, ROTEM®, Thromboelastometry
Plan
Vol 75
Article 110484- décembre 2021 Retour au numéro
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