Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy pregnant Australian women: a comparison of labouring and non-labouring women at term.

Autor: Lee J; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, QLD, Australia. Electronic address: Julie.Lee@health.qld.gov.au., Wyssusek KH; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, QLD, Australia., Kimble RMN; The University of Queensland, QLD, Australia; Department of Obstetrics and Gynaecology, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia., Way M; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia., van Zundert AA; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia., Cohen J; The University of Queensland, QLD, Australia; Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia., Rowell J; The University of Queensland, QLD, Australia; Department of Haematology, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia., Eley VA; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, QLD, Australia.
Jazyk: angličtina
Zdroj: International journal of obstetric anesthesia [Int J Obstet Anesth] 2020 Feb; Vol. 41, pp. 7-13. Date of Electronic Publication: 2019 Nov 18.
DOI: 10.1016/j.ijoa.2019.10.003
Abstrakt: Background: Rotational thromboelastometry (ROTEM®) is a point-of-care coagulation test. Reference ranges in non-labouring women have recently been established from a cohort of women presenting for elective caesarean delivery using the recommended minimum sample size of 120. This study aimed to present baseline parameters for labouring and non-labouring women and to compare the mean values of these ROTEM® parameters.
Methods: Ethical approval was granted for an opt-out recruitment approach for labouring women and written consent was obtained from non-labouring women (data published previously). ROTEM® testing was performed in these two cohorts at term gestation. Women with any condition affecting coagulation were excluded. ROTEM® Delta reference ranges were derived by calculating the 2.5 and 97.5 percentiles for INTEM/EXTEM/FIBTEM amplitude at 5 min (A5), coagulation time (CT), maximum clot firmness (MCF) and clot formation time (CFT).
Results: One hundred and twenty-one labouring and 132 non-labouring women met inclusion criteria. The mean values for selected ROTEM® parameters for labouring and non-labouring women respectively were: FIBTEM A5, 21.05 and 19.7 mm (P=0.008); EXTEM A5, 54.8 and 53.2 mm (P=0.025); and EXTEM CT, 52.2 and 53.7 s (P=0.049). Significant differences between the groups were observed in measures of clotting onset and clot firmness.
Conclusions: We demonstrated a significant decrease in the mean time-to-clotting onset in labouring women compared with non-labouring women. Mean values for measures of clot firmness were greater in labouring women. In comparison to previously established ROTEM® baseline parameters for non-labouring women, this study provides evidence that there is greater hyper-coagulability in labouring women.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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