Rotational thromboelastometry (ROTEM ® ) in gestational diabetes mellitus and coagulation in healthy term pregnancy: A prospective observational study in Australia.

Autor: Lee J; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Eley VA; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Wyssusek KH; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Kimble RMN; The University of Queensland, Brisbane, Queensland, Australia.; Department of Obstetrics, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia., Way M; QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia., van Zundert AA; Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2022 Jun; Vol. 62 (3), pp. 389-394. Date of Electronic Publication: 2022 Jan 07.
DOI: 10.1111/ajo.13474
Abstrakt: Background: Rotational thromboelastometry (ROTEM ® ) is a point-of-care test of coagulation. ROTEM ® -defined hypercoagulability has been identified in pregnant women and in non-pregnant patients with diabetes mellitus. Pregnancy is known to be a hypercoagulable state, but the influence of gestational diabetes mellitus (GDM) on coagulation is unknown.
Aim: The aim of this study was to assess the combined effect of pregnancy and GDM on coagulation using ROTEM ® and to compare this to healthy pregnant women presenting for elective caesarean delivery.
Materials and Methods: Ethics approval was granted for recruitment of women presenting for elective caesarean delivery. Women with pre-existing conditions affecting coagulation were excluded. Group N included health pregnant women at term and Group G included pregnant women at term with GDM. Data regarding GDM management and glycaemic control were collected. Poor glycaemic control was defined by markers of accelerated fetal growth and elevated fasting or postprandial blood glucose levels. The ROTEM ® parameters (extrinsically activated thromboelastometric test (EXTEM) / fibrin polymerisation test (FIBTEM) amplitude at five minutes, coagulation time, maximum clot firmness and clot formation time) were compared between the two groups using Student's t-test.
Results: There were 75 women in Group N and 21 women in Group G. Mean age and median body mass index values were comparable for both groups. There were no statistical differences found between the EXTEM and FIBTEM parameters analysed for the two groups.
Conclusions: There was no association between GDM and increased hypercoagulability as demonstrated by ROTEM ® parameters in healthy pregnant women presenting for elective caesarean delivery at term.
(© 2022 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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