Thromboelastography predicts risks of obstetric complication occurrence in (hypo)dysfibrinogenemia patients under non-pregnant state

Autor:	Lin-lin Jiang, Qian Liang, Qiulan Ding, Xi Wu, Yu Xin, Yaopeng Chen, Jingyi Zhou, Hongli Wang, Jing Dai, Xuefeng Wang, Yeling Lu
Rok vydání:	2016
Předmět:	Adult Risk medicine.medical_specialty Physiology 030204 cardiovascular system & hematology Fibrinogen Asymptomatic 03 medical and health sciences 0302 clinical medicine Pregnancy Physiology (medical) medicine Humans Dysfibrinogenemia Kaolin Pharmacology Receiver operating characteristic medicine.diagnostic_test Obstetrics business.industry Odds ratio Afibrinogenemia medicine.disease Confidence interval Thromboelastography Thrombelastography Pregnancy Complications 030220 oncology & carcinogenesis Female medicine.symptom business medicine.drug
Zdroj:	Clinical and Experimental Pharmacology and Physiology. 43:149-156
ISSN:	0305-1870
DOI:	10.1111/1440-1681.12509
Popis:	Congenital (hypo)dysfibrinogenemia patients may have obstetric complications during their pregnancies. This study aimed to evaluate thromboelastography (TEG) as a potential tool for assessing the tendency for obstetric complications in those patients in a non-pregnant state. A total of 22 female subjects with congenital (hypo)dysfibrinogenemia were recruited. Nine subjects had histories of obstetric complications and the other 13 subjects had at least one uneventful pregnancy without obstetric complications as yet. Detailed clinical investigation and phenotype/genotype detection were carried out, and both kaolin-activated TEG and functional fibrinogen TEG (FF-TEG) were applied in all subjects. Significant differences were identified in all TEG parameters except for R and angle between these two groups (P < 0.05) by covariance analysis. Receiver operating characteristic (ROC) analysis of discrimination between these two groups of patients was performed for TEG parameters. Significantly high odds ratio (OR) of obstetric complications occurrence were demonstrated in K ≥ 3.8 min, maximum amplitude (MA) ≤ 54.2 mm, comprehensive index (CI) ≤ -3 (11.67, 95% CI 1.527-89.121, P < 0.05 in all), and MA-CFF ≤ 12.1 mm (20.00, 95% confidence interval (95% CI) 1.967-203.322, P = 0.002). Moreover, MA-CFF had better prognostic performance, with a corresponding area under the receiver operating curve of 0.923 (range 0.815-1.031, P = 0.001). This study suggests that (hypo)dysfibrinogenemia patients with values outside of the cut-off values of TEG assays under non-pregnant state may have a higher risk of obstetric complications occurring when they are pregnant. No parameters under non-pregnant state in clinical laboratory have ever been reported to be risk factors for obstetric complication occurrence in (hypo)dysfibrinogenemia patients. This study explored such parameters in TEG assays and found that parameters of TEG assays under non-pregnant status might predict the occurrence of obstetric complications, which could provide physicians with important information about whether fibrinogen replacement therapy is required, so as to prevent the occurrence of obstetric complications, especially for patients who are asymptomatic in daily life.
Databáze:	OpenAIRE
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