Assessment of Coagulation Profiles in Healthy Term Pregnant Women Using a Thrombelastography

Background: In general, pregnancy is considered a hypercoagulable state, and an increased incidence of thromboembolic phenomena have been reported in pregnant women. A thrombelastography (TEG) measures whole blood coagulation and fibrinolysis, and has been used to manage coagulation defects in patients. The purpose of this study was to establish the physiologic changes in the coagulation and fibrinolytic systems in a normal term pregnancy using a TEG. Methods: A TEG was performed in 31 nonpregnant women and 31 healthy pregnant women using native whole blood. The TEG variables included reaction time (R), clot formation time (K), maximum amplitude (MA), angle, TEG coagulation index and percentage of reduction in MA at 30 minutes (LY30) and 60 minutes (LY60). Other laboratory tests such as hemoglobin (Hgb), hematocrit (Hct), platelet count (PC) and routine coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (aPTT) and bleeding time (BT) were measured in all women. Results: The R and K were significantly decreased in pregnant women compared with nonpregnant women (P 0.05). The MA, angle, LY30 and LY60 were significantly increased in pregnant women compared with nonpregnant women (P 0.05). The TEG coagulation index was significantly greater in pregnant women compared with nonpregnant women (P 0.05). Conclusions: In this study, the TEG showed that term pregnant women were in a hypercoagulable state and had increased fibrinolysis.