Platelet Counts and Coagulation Tests Prior to Neuraxial Anesthesia in Patients With Preeclampsia

Sultan, Pervez; Butwick, Alexander J.

doi:10.1177/1076029612441860

Cited by 23 publications

(9 citation statements)

References 29 publications

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“…The parameters of blood coagulation function for all subjects in our study trended toward increasing coagulation; this was true for women who had both healthy pregnancies and preeclamptic pregnancies ( Figure 1.A and D ). The APTT and the PT of all subjects reflects the function of endogenous and exogenous coagulative pathways, respectively [14] . Interestingly, further research has shown that the differences in significance for APTT and PT are mainly attributed to changes in the normal group ( Figure 1 .A and D).…”

Section: Discussionmentioning

confidence: 99%

Blood Coagulation Parameters and Platelet Indices: Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia

et al. 2014

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BackgroundPreeclampsia (PE) is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE.ObjectivesWe aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE.MethodsBlood samples from 3 groups of subjects, normal pregnant women (n = 79), mild preeclampsia (mPE) (n = 53) and severe preeclampsia (sPE) (n = 42), were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC) curves of these indices were generated, and the area under the curve (AUC) was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis.ResultsDuring late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV) increased compared to early pregnancy (p<0.05). However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD) during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743) and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671) and ideal predictive efficiency.ConclusionNormal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE, respectively.

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Section: Discussionmentioning

confidence: 99%

Blood Coagulation Parameters and Platelet Indices: Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia

et al. 2014

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“…PT, APTT, TT, FDP, FIB, D-D, and AT-measurements are routine coagulation tests used to assess coagulation systems prior to renal biopsy. The APTT and the PT re ect the function of endogenous and exogenous pathways of the coagulation cascade [20], and its duration could be affected by the upstream Xa factor common to coagulation activation pathways. Reports suggested that factor Xa could cooperate with V to exert procoagulant activity in active IgAN, leading to intra-mesangial coagulation [21,22].…”

Section: Discussionmentioning

confidence: 99%

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

Xia

Liu

Peng

et al. 2020

Preprint

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Background: Interstitial fibrosis/tubular atrophy (T) score is a known determinant of the progression of immunoglobulin A nephropathy (IgAN). Strong evidence indicates that the components of the coagulation system closely linked with fibrotic events and have been highlighted in the kidney. However, whether the coagulation system can affect the renal outcome of IgAN remains unclear. Herein, we investigated the association of coagulation parameters and pathological phenotype of IgAN and their combined effects on the deterioration of renal function.Methods: This retrospective study included patients with biopsy-proven IgAN from May 2009 to April 2013 in the Second Xiangya Hospital. Clinical data, pathological features were collected, and the associations of coagulation parameters at biopsy, T score, and renal outcome were evaluated. T score indicated the degree of tubular atrophy or interstitial fibrosis. The renal outcome was defined as an end-stage renal disease (ESRD) or an irreversible 50% estimated glomerular filtration rate (eGFR) reduction.Results: Shorter prothrombin time (PT) and the activated partial thromboplastin time (APTT) were significantly associated with T (both p<0.001). PT (<11.15s) or APTT (<29.65s) had worse cumulative survival rate (p=0.008, p=0.027 respectively) and were significantly but not independently associated with a higher risk of renal outcome (p=0.012, p=0.032 respectively). In the combined analyses of PT, APTT, and T lesions, the odd ratios for the outcome were significantly higher in the presence of T with PT (<11.15s) or APTT (<29.65s).Conclusion: Shorter PT and APTT are associated with an increased incidence of the T lesion and are additional factors that portend a poorer prognosis in IgAN. Monitoring coagulation function might be important when assessing the risk of progression. Additional studies exploring the molecular mechanism between coagulation and IgAN pathology are needed.

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“…PT, APTT, TT, FDP, FIB, D-D, and AT-measurements are routine coagulation tests used to assess coagulation systems prior to renal biopsy. The APTT and the PT re ect the function of endogenous and exogenous pathways of the coagulation cascade (24), and its duration could be affected by the upstream Xa factor common to coagulation activation pathways. Reports suggested that factor Xa could cooperate with V to exert procoagulant activity in active IgAN, leading to intra-mesangial coagulation (25,26).…”

Section: Discussionmentioning

confidence: 99%

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

Xia

Liu

Peng

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Interstitial fibrosis/tubular atrophy (T) score is a known determinant of the progression of immunoglobulin A nephropathy (IgAN). Strong evidence indicates that the components of the coagulation system closely linked with fibrotic events have been highlighted in the kidney. However, whether the coagulation system can affect the renal outcome of IgAN remains unclear. Herein, we investigated the association of coagulation parameters and pathological phenotype of IgAN and their combined effects on the deterioration of renal function. Methods: This retrospective study included N=291 patients with biopsy-proven IgAN from May 2009 to April 2013 in the Second Xiangya Hospital. Clinical data, pathological features were collected, and the associations of coagulation parameters at biopsy, T score, and renal outcome were evaluated. T score indicated the degree of tubular atrophy or interstitial fibrosis. The renal outcome was defined as an end-stage renal disease (ESRD) or an irreversible 50% estimated glomerular filtration rate (eGFR) reduction. Results: Shorter prothrombin time (PT) and the activated partial thromboplastin time (APTT) were significantly associated with T (both p<0.001). PT (<11.15s) or APTT (<29.65s) had worse cumulative survival rate (p=0.008, p=0.027 respectively) and were significantly but not independently associated with a higher risk of renal outcome (p=0.012, p=0.032 respectively). In the combined analyses of PT, APTT, and T lesions, the odd ratios for the outcome were significantly higher in the presence of T with PT (<11.15s) or APTT (<29.65s). Conclusion: Shorter PT and APTT are associated with an increased incidence of the T lesion and are additional factors that portend a poorer prognosis in IgAN. Monitoring coagulation function might be important when assessing the risk of progression. Additional studies exploring the molecular mechanism between coagulation and IgAN pathology are needed.

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Platelet Counts and Coagulation Tests Prior to Neuraxial Anesthesia in Patients With Preeclampsia

Cited by 23 publications

References 29 publications

Blood Coagulation Parameters and Platelet Indices: Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia

Blood Coagulation Parameters and Platelet Indices: Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

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