Reference values for a wide range of ROTEM thromboelastogram parameters at different stages of physiological pregnancy
Abstract
Assessing the hemostatic balance in pregnant women is an important aspect of clinical practice. ROTEM thromboelastometry (TEM) is a method that assesses the quality of blood coagulation, including the speed, strength and absorption of the formed clot. Reference values are an important indicator of the function of a blood coagulation system that is specific to each individual. In pregnant women, the function of blood coagulation changes due to physiological adaptations that occur in the body during pregnancy. Therefore, the evaluation of the reference values of TEM in pregnant women is a necessary step to determine the normal parameters of blood coagulation in this particular group of patients.
Methods. Within the framework of the prospective study, data were obtained on 1,000 women in the first, second and third trimesters, observed at the Moscow Regional Research Institute of Obstetrics and Gynecology, examined in the clinic diagnostic laboratory of the Medical Laboratory in the period from May 2013 to May 2023. The criterion for inclusion in the study group was physiological pregnancy in different gestation periods, the age of women from 18 to 38 years. The criterion of exclusion: patients receiving anti-aggregation and anticoagulant therapy on condition, patients with blood diseases, multiple pregnancies. Rotary TEM was performed on the ROTEM Delta (Pentapharm GmbH, Germany), according to the standard execution protocol.
Results. NATEM, INTEM, EXTEM and FIBTEM tests were performed, calculated the full range of indicators: CT, s; A5, mm; A10, mm; A15, mm; A20, mm; A25, mm; A30, mm; CFT, с; MCF, %; MCF-t, s; Alpha, º; LI30, %; LI45, %; LI60, %; ML, %; CFR, º; LOT, с; CLR, ˚; AR5, мм2; AR10, mm2; AR15, mm2; AR20, mm2; AR25, mm2; AR30, mm2; MCE; ACF, mm; G; TPI; MAXV, mm/min; MAXV-t, s; AUC; LT, s.
Conclusion. The resulting reference values will allow obstetrician gynecologists to interpret more correctly ROTEM estimates and treatment of patients with hypercoagulation and high risk of bleeding.
