Study of coagulation function in women at late pregnancy and establishment of reference interval of thromboelastography
Objective:To examine the role of thromboelastography(TEG)and the four coagulation items in the identification of coagulation function in women in late pregnancy,as well as to determine the reference interval of TEG for healthy women in late pregnancy.Methods:A total of 546 cases of women at late pregnancy who came to our hospital from January 2022 to December 2023 were selected as study subjects,all of whom were healthy women with singleton pregnancy.In the same period,116 women in early pregnancy,145 women in mid-pregnan-cy and 107 non-pregnant women were selected to be included in the early pregnancy group,the mid-pregnancy group and the control group.We retrospectively analyzed the TEG indexes:reaction time(R),clot kinetics(K),clot strengthening(Angle),maximum amplitude(MA)and the four coagulation items:prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)of the four groups,and explored the correlation of these two items in coagulation testing of subjects.To establish a preliminary TEG ref-erence interval for healthy women at late pregnancy in our laboratory.Results:Compared with the control group,the TEG results of women in early pregnancy,mid-pregnancy and late pregnancy showed a significant decrease in R and K,and a significant increase in Angle and MA(P＜0.05).The PT,APTT and TT of women in mid-preg-nancy and late pregnancy were significantly lower than those of the control group,and FIB was significantly higher than that of the control group(P＜0.05).The APTT,TT of women in early pregnancy were significantly lower than those of the control group,and FIB was significantly higher than that of the control group(P＜0.05).When comparing between groups of pregnant women,K,PT and APTT were lower in the late and middle pregnancy groups than in the early pregnancy group;Angle,MA and FIB were higher than in the early pregnancy group,and the differences were statistically significant(P＜0.05).There were also significant differences in MA,FIB and TT between women in the late pregnancy group compared with those in the middle pregnancy group(P＜0.05).A total of 546 women in late pregnancy had a significant positive correlation between R and APTT;a significant negative correlation between K and FIB;and a significant positive correlation between Angle and FIB or MA and FIB(P＜0.05).The preliminary TEG medical reference ranges for healthy women in late pregnancy in our labora-tory were R:4.2 to 8.7 min;K:0.9 to 2.7 min;Angle:56.3° to 75.8°;and MA:56.4 to 73.7 mm,respective-ly.The differences were statistically significant when compared with the reference ranges provided by the manu-facturer(P＜0.05).Conclusion:TEG and the four coagulation items can promptly detect hypercoagulability in women in late pregnancy,and assist clinicians in the timely detection of thrombotic diseases and adverse complica-tions.The two can complement each other,not replace each other,and the combined test has important clinical value.The reference range of TEG for healthy women in late pregnancy in our laboratory was initially established.
thromboelastographythe four coagulation itemslate pregnancyreference interval
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