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thromboelastography and pregnancy

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https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#1
S Griffiths, C Woo, V Mansoubi, A Riccoboni, A Sabharwal, S Napier, M Columb, M Laffan, G Stocks
BACKGROUND: Low molecular weight heparin is routinely used for thromboprophylaxis in pregnancy and the puerperium. Consensus guidelines recommend waiting 10-12h after administration of a thromboprophylactic dose of low molecular weight heparin before performing a neuraxial block or removing an epidural catheter. Thromboelastography (TEG®) has been reported to be sensitive to the effects of enoxaparin 4h after administration. The purpose of this study was to use TEG to examine coagulation changes in the first 10h after a thromboprophylactic dose of tinzaparin in an attempt to ratify the current consensus guidelines about timing of neuraxial blockade and epidural catheter removal...
October 8, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27717636/the-effect-of-dalteparin-on-thromboelastography-in-pregnancy-an-in-vitro-study
#2
L Chow, A Carr, L MacKenzie, A Walker, D Archer, A Lee
BACKGROUND: Dalteparin is often used for prophylaxis or treatment of venous thromboembolism during pregnancy, yet there is no laboratory test to accurately reflect its clinical activity. Thromboelastography is a point-of-care monitor of whole blood coagulation. The aim of this study was to determine if serial doses of dalteparin added in vitro to whole blood samples from term, pregnant women are detectable as changes in thromboelastography parameters. METHODS: Thirty healthy parturients presenting for elective caesarean section were recruited...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27451401/changes-in-thromboelastography-parameters-in-pregnancy-labor-and-the-immediate-postpartum-period
#3
Norman E Shreeve, John A Barry, Leah R Deutsch, Keith Gomez, Rezan A Kadir
OBJECTIVE: To demonstrate changes in clot mechanics during pregnancy, and to determine the effect that delivery has on immediate postpartum thromboelastography parameters. METHODS: In an observational cross-sectional/longitudinal study, thromboelastography was performed on whole blood aliquots obtained from women carrying singleton pregnancies attending a center in London, UK, between December 2013 and March 2014. Thromboelastography was repeated 6hours after delivery among patients recruited in the third trimester or labor...
September 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27124733/moderate-exercise-attenuates-lipopolysaccharide-induced-inflammation-and-associated-maternal-and-fetal-morbidities-in-pregnant-rats
#4
Karina T Kasawara, Tiziana Cotechini, Shannyn K Macdonald-Goodfellow, Fernanda G Surita, João L Pinto E Silva, Chandrakant Tayade, Maha Othman, Terence R S Ozolinš, Charles H Graham
Fetal growth restriction (FGR) and coagulopathies are often associated with aberrant maternal inflammation. Moderate-intensity exercise during pregnancy has been shown to increase utero-placental blood flow and to enhance fetal nutrition as well as fetal and placental growth. Furthermore, exercise is known to reduce inflammation. To evaluate the effect of moderate-intensity exercise on inflammation associated with the development of maternal coagulopathies and FGR, Wistar rats were subjected to an exercise regime before and during pregnancy...
2016: PloS One
https://www.readbyqxmd.com/read/26881854/an-observational-study-of-haemostatic-changes-leptin-and-soluble-endoglin-during-pregnancy-in-women-with-different-bmis
#5
Ellie S Morgan, Ellie Wilson, Therese Melody, Kiran Parmar, Yan Zhang, Fang Gao, Beverley J Hunt
Obesity increases the risk of venous thromboembolism (VTE) in pregnancy. The pathogenesis is hypothesized to be because of multiple factors including prothrombotic changes, but there has been minimal haemostatic research looking at the combined state of obesity and pregnancy. We aimed to determine whether variation in BMI in the third trimester of pregnancy was associated with prothrombotic changes. We recruited 110 women into four groups depending on their BMI at first antenatal appointment: normal, overweight, obese and morbidly obese...
February 12, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/26510121/thromboelastography-predicts-risks-of-obstetric-complication-occurrence-in-hypo-dysfibrinogenemia-patients-under-non-pregnant-state
#6
Jingyi Zhou, Yu Xin, Qiulan Ding, Linlin Jiang, Yaopeng Chen, Jing Dai, Yeling Lu, Xi Wu, Qian Liang, Hongli Wang, Xuefeng Wang
Congenital (hypo)dysfibrinogenemia patients may have obstetric complications during their pregnancies. This study aimed to evaluate thromboelastography (TEG) as a potential tool for assessing the tendency for obstetric complications in those patients in a non-pregnant state. A total of 22 female subjects with congenital (hypo)dysfibrinogenemia were recruited. Nine subjects had histories of obstetric complications and the other 13 subjects had at least one uneventful pregnancy without obstetric complications as yet...
February 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/25787577/-227-pos-thromboelastography-teg-%C3%A2-and-rotational-thromboelastometry-rotem-%C3%A2-in-pregnancy-a-systematic-review
#7
Antoinette C Bolte, Frederik J Hermans, Leonie E Van Rheenen-Flach
OBJECTIVES: To evaluate the current position of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) in clinical obstetric practice. METHODS: A search of the literature was performed on the following databases PubMed MEDLINE, EMBASE and the Cochrane Database of Systematic reviews. All articles published after 1990 until February 2013 and written in English, German, French, Spanish, Italian and Dutch concerning human pregnancies were eligible for inclusion...
January 2015: Pregnancy Hypertension
https://www.readbyqxmd.com/read/25594216/establishing-thromboelastography-with-platelet-function-analyzer-reference-ranges-and-other-measures-in-healthy-term-pregnant-women
#8
Kathleen M Antony, Roshanak Mansouri, Melanie Arndt, Shiu-Ki Rocky Hui, Purviben Jariwala, Virginia Moreland Mcmullen, Jun Teruya, Kjersti Aagaard
OBJECTIVE: The diagnosis of coagulopathy cannot always be performed at point of care. Thromboelastography (TEG) and the platelet-function analyzer (PFA-100), have emerged as reliable means for coagulation analysis. However, their reliable utility in pregnancy remains to be determined. We sought to establish reference values with concomitant determination of other known coagulation measures in nonlaboring gravidae in an effort to report the mean and variance of multiple testing modalities...
May 2015: American Journal of Perinatology
https://www.readbyqxmd.com/read/25549988/the-impact-of-advanced-maternal-age-on-peripartum-thromboelastographic-coagulation-profiles-a-prospective-observational-exploratory-study
#9
Alexander Butwick, Maria C Gutierrez, Gillian Hilton
PURPOSE: Advanced maternal age (AMA) is a known risk factor for pregnancy-related venous thromboembolism. However, it is unclear if underlying differences exist in the maternal coagulation profiles of AMA vs non-AMA women. The aim of this prospective observational study was to compare peripartum thromboelastography parameters of AMA and non-AMA women undergoing elective Cesarean delivery (CD). METHODS: We compared the peripartum thromboelastographic profiles of healthy AMA women (age > 35 yr) and non-AMA women (age ≤ 35 yr) undergoing elective CD under neuraxial anesthesia...
May 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25535433/the-hypercoagulable-states-in-anaesthesia-and-critical-care
#10
REVIEW
Bala D Bande, Saroj B Bande, Suchitra Mohite
Hypercoagulable disorders are now diagnosed more frequently than before. These patients are, usually, managed with multiple anticoagulant and antiplatelet medications. Left unmonitored and unevaluated, there can be disastrous haemorrhagic or thrombotic complications. Appropriate perioperative and anaesthetic management of these patients will invite an aetiological diagnosis, severity analysis and the on-going treatment review. Different assays, thromboelastography and molecular cytogenetics have helped to diagnose these conditions precisely and thus guide the long-term management...
September 2014: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/24902455/utility-of-thromboelastography-during-neuraxial-blockade-in-the-parturient-with-thrombocytopenia
#11
Jeffrey Huang, Nicholas McKenna, Noah Babins
No consensus exists on when it is safe to administer neuraxial blockade in a patient with a low platelet count. It has been suggested that thromboelastography (TEG) may be useful in assessing platelet function in parturients with thrombocytopenia. The purpose of the study was to analyze the incidence of neurologic complications, if any, related to regional anesthesia in parturients with a platelet count less than 100,000 mm-3 and especially those with less than 80,000 mm3 and normal TEG values. The data were prospectively collected during a 3-year period...
April 2014: AANA Journal
https://www.readbyqxmd.com/read/24698684/thromboelastography-in-women-with-pathological-pregnancies-a-preliminary-study
#12
Wei Wang, Ai-ming Wang, Xin-qiang Huang, Wen Jiang, Xiao-ning Jia
ABNORMALITIES during pregnancy are regarded as pathological pregnancy. Early detection of anomalies is urgent to take measures as soon as possible to prevent serious pregnancy complications. Procoagulant-anticoagulant imbalance is often the pathological basis of many pathological pregnancy conditions, leading to a hypercoagulable state. We compared the thromboelastographic parameters between pathological pregnancy and normal pregnancy patients, evaluated the value of thromboelastography in early detecting pathological pregnancy and predicting postpartum hemorrhage...
March 2014: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/24342222/major-obstetric-haemorrhage-monitoring-with-thromboelastography-laboratory-analyses-or-both
#13
O Karlsson, A Jeppsson, M Hellgren
BACKGROUND: Haemorrhage is a common cause of morbidity and mortality in the obstetric population. The aim of this study was to compare the use of thromboelastography and laboratory analyses to evaluate haemostasis during major obstetric haemorrhage. A secondary aim was to evaluate correlations between the results of thromboelastography, laboratory analyses and estimated blood loss. METHODS: Forty-five women with major obstetric haemorrhage and 49 women with blood loss <600 mL were included...
February 2014: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/23465802/use-of-thromboelastography-to-assess-the-combined-role-of-pregnancy-and-obesity-on-coagulation-a-prospective-study
#14
S Sharma, J Uprichard, A Moretti, H Boyce, R Szydlo, G Stocks
BACKGROUND: Thromboelastography (TEG®) is a point of care monitor of whole blood coagulation and has previously demonstrated hypercoagulability in both pregnant and obese populations. However, the individual and combined contribution of pregnancy and obesity on coagulation status has not been defined. We carried out a study to assess the effect of both pregnancy and body mass index (BMI) on blood coagulation using laboratory tests of coagulation and thromboelastography. METHODS: This was a prospective study of 96 women divided into four equal groups; non-pregnant lean (NPL) BMI <25kg/m(2), pregnant lean (PL) BMI <25kg/m(2), non-pregnant obese (NPO) BMI >35kg/m(2) and pregnant obese (PO) BMI >35kg/m(2)...
April 2013: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/23182609/the-impact-of-spinal-anaesthesia-for-caesarean-delivery-on-coagulation-assessed-by-thromboelastography
#15
A Fassoulaki, C Staikou
BACKGROUND: Pregnancy and puerperium are associated with a hypercoagulable state. The aim of the study was to assess the impact of spinal anaesthesia on coagulation using thromboelastography in healthy term pregnant women undergoing elective caesarean delivery. METHODS: Thromboelastography was performed on 60 women undergoing elective caesarean delivery under spinal anaesthesia. As spinal anaesthesia has different effects on upper and lower extremity vasculature, venous blood samples were collected from both hand and foot, before and one hour after spinal injection...
January 2013: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/22993925/-endogenous-heparin-like-syndrome-analysis-of-clinical-observations
#16
A Iu Bulanov, K V Iatskov, E M Shulutko, T E Glukhova, S A Andreĭchenko
One of the reasons for non-surgical bleeding is heparin-like syndrome (HLS), under which is understanded presence of heparin effect in the absence of it's exogenous application. The role of endogenous heparins perform glycosaminoglycans -- biologically active substances. HLS is accompanied by endothelium damage and discussed in the network of the systemic inflammatory response syndrome (SIRS). HLS is described in liver future, sepsis, pregnancy and a number of hemoblastosis. Hypocoagulation effect of endogenous heparin localizates in X coagulation factor...
May 2012: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/22926249/obstetric-hemorrhage-and-coagulation-an-update-thromboelastography-thromboelastometry-and-conventional-coagulation-tests-in-the-diagnosis-and-prediction-of-postpartum-hemorrhage
#17
REVIEW
Natascha M de Lange, Marcus D Lancé, Reneé de Groot, Erik A M Beckers, Yvonne M Henskens, Hubertina C J Scheepers
Globally, postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality. In the current treatment of severe PPH, first-line therapy includes transfusion of packed cells and fresh-frozen plasma in addition to uterotonic medical management and surgical interventions. In persistent PPH, tranexamic acid, fibrinogen, and coagulation factors are often administered. Secondary coagulopathy due to PPH or its treatment is often underestimated and therefore remains untreated, potentially causing progression to even more severe PPH...
July 2012: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/22867727/postpartum-hemorrhage-management-in-2012-predicting-the-future
#18
Oluwatoyosi Onwuemene, David Green, Louis Keith
Transfusion therapy in postpartum hemorrhage (PPH) traditionally has been modeled after precedents set in the Vietnam and Korean wars. However, data from recent military combat casualties suggest a different transfusion strategy. Transfusion of packed red blood cells, fresh frozen plasma, and platelets in a ratio of 1:1:1 improves dilutional coagulopathy and survival. Women who present with low fibrinogen at the time of diagnosis of PPH have poorer outcomes and might benefit from early fibrinogen replacement...
October 2012: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/22822194/prospective-longitudinal-study-of-thromboelastography-and-standard-hemostatic-laboratory-tests-in-healthy-women-during-normal-pregnancy
#19
Ove Karlsson, Tommy Sporrong, Andreas Hillarp, Anders Jeppsson, Margareta Hellgren
BACKGROUND: Hemostatic disorders are common in obstetric complications. Thromboelastography (TEG®) simultaneously measures coagulation and fibrinolysis within 10 to 20 minutes. Our primary aim in this prospective longitudinal study was to obtain knowledge about physiological changes in TEG® variables during normal pregnancy and 8 weeks postpartum. The secondary aims were to compare TEG® variables during pregnancy with TEG® variables 8 weeks postpartum and gestational weeks 10 to 15 and to correlate TEG® variables to standard laboratory analyses...
October 2012: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/22805300/the-fib-pph-trial-fibrinogen-concentrate-as-initial-treatment-for-postpartum-haemorrhage-study-protocol-for-a-randomised-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Anne Juul Wikkelsoe, Arash Afshari, Jakob Stensballe, Jens Langhoff-Roos, Charlotte Albrechtsen, Kim Ekelund, Gabriele Hanke, Heidi Fosgrau Sharif, Anja U Mitchell, Jens Svare, Ane Troelstrup, Lars Møller Pedersen, Jeannet Lauenborg, Mette Gøttge Madsen, Birgit Bødker, Ann M Møller
BACKGROUND: Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality worldwide. In Denmark 2% of parturients receive blood transfusion. During the course of bleeding fibrinogen (coagulation factor I) may be depleted and fall to critically low levels, impairing haemostasis and thus worsening the ongoing bleeding. A plasma level of fibrinogen below 2 g/L in the early phase of postpartum haemorrhage is associated with subsequent development of severe haemorrhage. Use of fibrinogen concentrate allows high-dose substitution without the need for blood type crossmatch...
July 17, 2012: Trials
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