Baseline parameters for rotational thromboelastometry in healthy labouring women: a prospective observational study.

Autor: Lee J; Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.; The University of Queensland, St Lucia, QLD, Australia., Eley VA; Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.; The University of Queensland, St Lucia, QLD, Australia., Wyssusek KH; Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.; The University of Queensland, St Lucia, QLD, Australia., Kimble R; The University of Queensland, St Lucia, QLD, Australia.; Department of Obstetrics and Gynaecology, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia., Way M; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia., Coonan E; The University of Queensland, St Lucia, QLD, Australia.; Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia., Cohen J; The University of Queensland, St Lucia, QLD, Australia.; Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia., Rowell J; The University of Queensland, St Lucia, QLD, Australia.; Department of Haematology, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia., van Zundert AA; Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.; The University of Queensland, St Lucia, QLD, Australia.; Queensland University of Technology, Brisbane, QLD, Australia.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2020 Jun; Vol. 127 (7), pp. 820-827. Date of Electronic Publication: 2020 Feb 11.
DOI: 10.1111/1471-0528.16094
Abstrakt: Objective: The aim of this study was to establish rotational thromboelastometry (ROTEM ® ) baseline parameters in labouring women at term gestation. The secondary aim was to compare these reference ranges with those from previous studies on labouring women and from the manufacturer.
Design: A prospective, observational study.
Setting: Tertiary referral hospital.
Participants: Healthy women in labour.
Methods: Ethics approval was granted for an opt-out recruitment approach. ROTEM ® testing was performed in labouring women 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% centiles for INTEM/EXTEM/FIBTEM parameters including amplitude at 5 minutes (A5), coagulation time (CT) and maximum clot firmness (MCF).
Main Outcome Measures: ROTEM ® parameters were measured in labouring women before delivery. The following tests were performed: FIBTEM, EXTEM and INTEM.
Results: One hundred and twenty-one women met the inclusion criteria, with a mean (± SD) age of 29.6 ± 5.4 years and median (interquartile range) gestation of 39.4 weeks (37.4-40.4 weeks). Seventy-five (62.0%) women were nulliparous and 71 (58.7%) delivered vaginally. The median and interquartile ranges for selected ROTEM ® parameters were: FIBTEM A5, 21 mm (IQR 18-23 mm); EXTEM A5, 55 mm (52-58 mm); and EXTEM CT, 52 seconds (48-56 seconds).
Conclusions: The FIBTEM/EXTEM/INTEM amplitudes were higher than the manufacturer's reference ranges for non-obstetric patients. The FIBTEM MCF upper and lower limits were higher and the EXTEM/INTEM CT was shorter and narrower in range. This study provides reference ranges for ROTEM ® values in healthy labouring women at term gestation with uncomplicated pregnancies.
Tweetable Abstract: This is the first study to report on ROTEM ® reference ranges with over 120 healthy labouring women of normal weight at term gestation.
(© 2020 Royal College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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