Thromboelastography in term neonates.

Autor: Schott NJ; a Department of Anesthesiology , University of Pittsburgh , Pittsburgh , PA , USA., Emery SP; b Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Ultrasound , University of Pittsburgh , Pittsburgh , PA , USA., Garbee C; a Department of Anesthesiology , University of Pittsburgh , Pittsburgh , PA , USA., Waters J; c Department of Anesthesiology and Bioengineering , Magee Womens Hospital of UPMC , Pittsburgh , PA , USA.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2018 Oct; Vol. 31 (19), pp. 2599-2604. Date of Electronic Publication: 2017 Jul 11.
DOI: 10.1080/14767058.2017.1349747
Abstrakt: Background: Thromboelastography (TEG) is utilized as a point-of-care test of coagulation function to improve evidence-based blood product replacement in adults. In contrast to standard indices of coagulation, TEG reflects the dynamic interactions among the elements involved in hemostasis, including fibrinolysis. Although normal adult values and various abnormalities have been characterized, normative values for term neonates have not been described. Studies of neonatal TEG remain limited and have small sample sizes with inconsistent methodology. The aim of this study is to provide normative data on healthy term neonates, and to assess the impact of mode of delivery on TEG parameters at term.
Methods: Venous umbilical blood was obtained from the placenta within 10 min of delivery. TEG analysis of citrated kaolin-activated samples was performed for 50 healthy term vaginal and 50 cesarean deliveries. Samples collected for cesarean sections were from scheduled cases or unscheduled ones due to failure of progression of labor.
Results: Healthy neonates with uncomplicated vaginal term deliveries resulted in the following TEG parameters: R: 5.41 ± 1.34 (mean ± SD) min; K: 1.62 ± 0.75 min; α-angle: 65.39 ± 8.77°; MA: 65.86 ± 5.81 mm; and LY30: 1.40 ± 1.18%. Results for the cesarean delivery neonatal TEG assays showed: R: 5.51 ± 1.74 (mean ± SD) min; K: 1.52 ± 0.47 min; α-angle: 64.15 ± 4.61°; MA: 64.15 ± 4.61 mm; and LY30: 2.44 ± 3.51%. Of note, no statistical differences were observed (p < .01) between the groups.
Conclusion: TEG measurements from term neonates were no different when the neonates were delivered vaginally or by cesarean section. Labor had no effect on neonatal TEG levels. Neonatal TEG values may therefore serve as insight for fetal values at the appropriate postconceptional age.
Databáze: MEDLINE