How Can Rotational Thromboelastometry as a Point-of-Care Method Be Useful for the Management of Secondary Thromboprophylaxis in High-Risk Pregnant Patients?
| Autor: | Ingrid Skornova, L Vadelova, Tomáš Bolek, Jela Ivankova, Matej Samoš, Marian Grendar, Jan Stasko, Lucia Stančiaková, Peter Kubisz, Miroslava Dobrotova, Jana Zolkova, Jan Danko, Pavol Holly |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.drug_class Clinical Biochemistry rotational thromboelastometry 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine R5-920 medicine Point of care Pregnancy 030219 obstetrics & reproductive medicine business.industry risky pregnancy Anticoagulant Heparin thromboembolism medicine.disease Thromboelastometry Anesthesia Hemostasis hemostasis Gestation business Postpartum period medicine.drug |
| Zdroj: | Diagnostics Diagnostics, Vol 11, Iss 828, p 828 (2021) Volume 11 Issue 5 |
| ISSN: | 2075-4418 |
| Popis: | Thromboprophylaxis with low-molecular-weight heparin (LMWH) for patients with a history of venous thromboembolism (VTE) is suggested. Rotational thromboelastometry (ROTEM®) represents an innovative point-of-care method enabling the complex and quick evaluation of hemostasis. However, there are only episodic cases of its use for hemostasis assessment and guidance of LMWH in pregnancy. Therefore, we provide the results of unique prospective and longitudinal monitoring of hemostasis in high-risk pregnant women, which we used for the individualized optimalization of secondary thromboprophylaxis. According to the shortening of clot formation time (CFT) in EXTEM (p = 0.0007 from the 26th gestational week vs. controls) and INTEM (p = 0.002 from the 35th gestational week), increase in alpha angle (AA) in EXTEM, INTEM, and HEPTEM, and the persistence of increase in maximum clot firmness (MCF) in EXTEM, INTEM, and HEPTEM (p < 0.001 from the 26th and 35th gestational week vs. controls for EXTEM and INTEM, p = 0.0012 from the 26th gestational week in HEPTEM), LMWH dose was modified. Even after the postpartum period, AA in EXTEM was steeper than in controls (p = 0.0007), indicating that hemostasis is not fully normalized after 6–8 weeks following delivery. Therefore, ROTEM may be a useful tool for the individual evaluation of the termination of anticoagulant thromboprophylaxis. |
| Databáze: | OpenAIRE |
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