Indicators of rotational thromboelastometry in preterm delivery

Abstract

Disrupted maternal, placental, and/or fetal hemostasis leads to gestational disorders, including preterm birth (PR). A quick and convenient assessment of the coagulation profile is important for a premature newborn. Aim - to compare the indicators of hemostasis in mothers and newborns with different gestational ages using rotational thromboelastometry. Materials and methods. The study analyzed the indicators of the hemostatic profile in women in labor and their newborns using the fib-tem test on the ROTEM® delta device. Three groups of mothers and their newborns were studied: the Group I - at a gestation period of 37-41 weeks, the Group II - 28-34 weeks, the Group III - 22-27 weeks. Results. In the Group III prematures, blood clotting time (257.1±87.29ʺ) is longer than that of the Group I - 43.3±21.48ʺ and the Group II - 52.5±25.03ʺ. Angle α is larger in the Group I and the Group II - 47.6±12.49; 79.9±4.62; 76.7±4.84 (degrees). Amplitudes of contraction (5, 10 min, maximum) of the Group II are lower than the Group I by 10-22%. In the Group III, the amplitudes correlate with the concentration of fibrinogen up to 2 g/l - 4.6±1.39; 8.0±3.00; 7.9±5.56 (mm). The smallest lysis in the Group III (1.8±2.38%) versus the Group I and the Group II (17.1±2.34%, 8.1±2.50%. Maternal indicators of the amplitude of the coagulation are higher at a shorter gestational age. Conclusions. Maternal indicators of the amplitude of coagulation exceed the indicators of newborns by 1.5-2 times - 18.8±7.89 versus 17.4±7.04; 22.0±3.34 vs. 15.2±11.37 and 20.8±9.22 vs. 7.9±5.56 (mm). Blood clotting time of extremely premature newborns (257.1±87.29ʺ s) is longer than that of full-term and moderately premature infants (43.3±21.48ʺ; 52.5±25.03ʺ). Amplitudes of contractions of newborns of the Group III at the 5th minute are three times smaller, and at the 10th minute they are twice as small as in the Group I and the Group II - 4.6±1.39; 13.2±3.34; 16.2±5.38 (mm) and 8.0±3.01; 15.5±4.34; 16.0±7.39 (mm). In the Group III, coagulation lysis is minimal (1.8±2.38% vs. 17.1±2.34%; 8.1±2.50%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflict of interest.