Effect of blood loss during caesarean section on coagulation parameters

Wasserloos, A.; Thomassen, M. C. L. G. D.; Costa, Serban-Dan; Zenclussen, Ana Claudia; Tchaikovski, Vadim; Hackeng, Tilman M.; Stickeler, Elmar; Tchaikovski, Svetlana

doi:10.1016/j.thromres.2021.03.010

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…The coagulation system undergoes physiological changes to reach a hypercoagulable state to prevent severe bleeding during delivery [ 12 ]. Most of the pregnant patients who experienced acute coronary syndrome (ACS) had no coronary artery disease before, and the pathological mechanism involved was mainly non-atherosclerosis [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of norepinephrine and phenylephrine on prothrombotic response in patients undergoing cesarean section under spinal anesthesia: protocol for a randomized, double-blind, controlled study

Tao,

Xie,

Ding

et al. 2024

Trials

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Background Norepinephrine and phenylephrine are commonly used vasoactive drugs to treat hypotension during the perioperative period. The increased release of endogenous norepinephrine elicits prothrombotic changes, while parturients are generally in a hypercoagulable state. Therefore, this trial aims to investigate whether there is a disparity between equivalent doses of prophylactic norepinephrine infusion and phenylephrine infusion on prothrombotic response in patients undergoing cesarean section under spinal anesthesia. Methods Sixty-six eligible parturients will be recruited for this trial and randomly assigned to the norepinephrine or phenylephrine group. The “study drug” will be administered at a rate of 15 ml/h starting from the intrathecal injection. The primary outcome are plasma coagulation factor VIII activity (FVIII: C), fibrinogen, and D-dimer levels. The secondary outcomes include hemodynamic variables and umbilical artery blood pH value. Discussion Our study is the first trial comparing the effect of norepinephrine and phenylephrine on prothrombotic response in patients undergoing cesarean section under spinal anesthesia. Positive or negative results will all help us better understand the impact of vasoactive drugs on patients. If there are any differences, this trial will provide new evidence for maternal choice of vasoactive medications in the perioperative period. Trial registration Chinese Clinical Trial Registry ChiCTR2300077164. Registered on 1 November 2023. https://www.chictr.org.cn/.

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Section: Introductionmentioning

confidence: 99%

Effect of norepinephrine and phenylephrine on prothrombotic response in patients undergoing cesarean section under spinal anesthesia: protocol for a randomized, double-blind, controlled study

Tao,

Xie,

Ding

et al. 2024

Trials

View full text Add to dashboard Cite

show abstract

“…One evidence for this complexity is that moderate blood loss during caesarean section hardly reduces thrombin generation but aggravates pregnancy-induced activated protein C (APC) resistance and combined deficiency of tissue factor pathway inhibitor (TFPI) and protein S, which can account for the increased thrombosis risk in early puerperium. 3 From a clinical standpoint, this may result in an increased risk for thrombosis, as well as hemorrhage. The mode of delivery, associated surgical procedures (i.e., curettage of uterine cavity for retained placenta cotyledons), comorbidities, anemia, and transfusion of blood components progressively increase the risk of both thrombotic and bleeding complications.…”

mentioning

confidence: 99%

The ART of Thromboprophylaxis in the Prevention of Gestational Venous Thromboembolism

Grandone

Barcellona

Intrieri

et al. 2022

Semin Thromb Hemost

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Assisted reproductive techniques (ART) allow infertile couples to conceive. Use of hormones to obtain a controlled ovarian stimulation and an adequate growth of the endometrium preparatory for embryo implantation are not riskless. Among others, thrombotic events can occur during the ovulation induction or pregnancy following ART. As the number of women approaching ART to conceive is steadily increasing, the issue of thrombotic risk in this setting is relevant. Data on the weight of each risk factor and on potential benefit of thromboprophylaxis are largely lacking. In this review, we discuss risk of venous thromboembolism during pregnancy following ART, with a focus on general (i.e.: age, body mass index, thrombophilia, bed rest, transfusions) and ART-specific (i.e., polycystic ovarian syndrome, ovarian hyperstimulation syndrome) risk factors. We also attempt to provide some suggestions to guide clinical practice, based on available data and studies performed outside ART.

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Relationship between stroke and estimated glucose disposal rate: results from two prospective cohort studies

Han,

Zhang,

Luo

et al. 2024

Lipids Health Dis

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Background Insulin resistance (IR) is a recognized contributor to stroke association, and the estimated glucose disposal rate (eGDR) is a dependable indicator of IR. However, the specific connections between eGDR, stroke prevalence, and overall mortality have not been thoroughly investigated. This study aimed to examine how eGDR correlates with stroke and overall death rate. Methods The study leveraged information from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. To unravel the data, the team utilized logistic regression, cox proportional hazards models, and restricted cubic splines (RCS) Sensitivity analyses excluded participants with a stroke history within the previous two years. Results were validated through analysis of the China Health and Retirement Longitudinal Study (CHARLS). Results A higher eGDR is like a protective shield against strokes, with those in the top eGDR quartile exhibited a 60% reduction in stroke association (OR = 0.40, 95% CI, 0.22–0.73, P = 0.003). Additionally, a higher eGDR correlates with a lower overall death rate (HR = 0.71, 95% CI, 0.52–0.98, P = 0.037), particularly in individuals without a history of stroke. RCS analysis demonstrated that eGDR's influence on stroke association follows a non-linear pattern. Subgroup analysis revealed that the protective effect of eGDR was stronger in non-diabetic and non-hypertensive individuals. Conclusion eGDR is inversely related to both stroke association and mortality, affirming its utility as a predictive marker of stroke.

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Effect of blood loss during caesarean section on coagulation parameters

Cited by 3 publications

References 34 publications

Effect of norepinephrine and phenylephrine on prothrombotic response in patients undergoing cesarean section under spinal anesthesia: protocol for a randomized, double-blind, controlled study

Effect of norepinephrine and phenylephrine on prothrombotic response in patients undergoing cesarean section under spinal anesthesia: protocol for a randomized, double-blind, controlled study

The ART of Thromboprophylaxis in the Prevention of Gestational Venous Thromboembolism

Relationship between stroke and estimated glucose disposal rate: results from two prospective cohort studies

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