Reference Intervals of Routine Coagulation Assays During the Pregnancy and Puerperium Period

Gong, Jiao-Mei; Shen, Yong; He, Yi

doi:10.1002/jcla.21956

Cited by 27 publications

(26 citation statements)

References 17 publications

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“…Coagulability gradually increases from the first to third trimesters [1] in pregnant women, becoming higher than in normal women [2] . Consistent with this, late pregnancy is characterized not only by changes in hormone secretion and liver metabolism, but higher coagulation indices [3] .…”

Section: Introductionsupporting

confidence: 65%

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Liu

Sun

Tao

et al. 2019

Preprint

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Background : To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/fibrinolysis disorders in antenatal Chinese women . Methods: Case control study. Fifty women had GDM and 132 did not (the NGDM group). Maternal plasma biochemistry and previous medical history were collected from perinatal health records. Antenatal coagulation/fibrinolysis were assessed using thromboelastography and traditional measures, then the relationship between coagulation/fibrinolysis and GDM was analyzed by multiple regression analysis. Results: GDM was significantly associated with higher activated partial thromboplastin time (odds ratio [OR] 1.5, 95% confidence interval [CI] 0.4–2.6); fibrinogen (OR 0.3, 95% CI 0.1–0.6); and percentage reduction in clot lysis after 30 min (OR 1.2, 95% CI 0.2–2.2), after adjustment for potential confounding factors. Both the intraoperative (238.2±71.0 ml vs . 286.0±102.4 ml, P =0.003) and 24-hour after surgery (270.7±99.8 ml vs . 314.7±131.1 ml, P =0.033) blood loss were lower and the prevalence of cesarean delivery (56.0% vs . 37.9%, P =0.027) was higher in the GDM group. There were no significant differences in the prevalence of maternal thrombotic events or maternal body mass before delivery. Conclusions: GDM is significantly associated with hypercoagulability and secondary hyperfibrinolysis in these antenatal Chinese women.

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Section: Introductionsupporting

confidence: 65%

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Liu

Sun

Tao

et al. 2019

Preprint

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“…Levels of alkaline phosphatase (ALP) rise due to production of placental isoenzyme, as well as a significant increase in bone isoenzyme in third trimester . Most studies have found that prothrombin time (PT) falls progressively from second trimester such that values are approximately 10–20% lower than pre‐conception values in third trimester . This may be important when considering abnormal hepatic synthetic function with disorders such as AFLP.…”

Section: Laboratory Investigationsmentioning

confidence: 81%

“…33,34,64,65,71,74 Most studies have found that prothrombin time (PT) falls progressively from second trimester such that values are approximately 10-20% lower than pre-conception values in third trimester. 33,75,76 This may be important when considering abnormal hepatic synthetic function with disorders such as AFLP. Serum amylase activity does not change significantly during pregnancy.…”

Section: Liver Testsmentioning

confidence: 99%

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

Morton

Teasdale

2018

Emerg Medicine Australasia

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Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point‐of‐care ultrasound and electrocardiography. In addition the emergency physician needs to be cognisant of disorders that are unique to or more common in pregnancy. Part 1 of this review addresses potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy, and the important causes of abnormal laboratory results in pregnancy. Part 2 will address the role of point‐of‐care ultrasound in pregnancy, physiological changes that may affect interpretation of point‐of‐care ultrasound, physiological changes in electrocardiography, and the safety of radiological procedures in the pregnant patient.

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“…The diagnosis of DIC in pregnancy requires a high index of suspicion, due to various laboratory changes in the gravid patient which make its diagnosis more challenging ( Table 1 ). These changes include hyperfibrinogenemia (normal 3 rd trimester value of approximately 5 g/L), decreased prothrombin (PT) and partial thromboplastin times (aPTT), and thrombocytopenia [ 1 , 4 , 5 , 14 , 15 ]. Therefore, hematologic laboratory results that align with normal values in the nongravid patient should elicit additional scrutiny by the clinician.…”

Section: Discussionmentioning

confidence: 99%

To Clot or Not: HELLP Syndrome and Disseminated Intravascular Coagulation in an Eclamptic Patient with Intrauterine Fetal Demise

Walker

Bonavia

2020

Case Reports in Anesthesiology

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A 39-year-old G2P1001 female presented from an outside hospital following an eclamptic seizure in the setting of HELLP syndrome. This condition was complicated by intrauterine fetal demise and disseminated intravascular coagulation, which required an emergent cesarean section. We report the work-up and intraoperative and postoperative management of this complex patient with multiple medical needs. We focus on the hemostatic abnormalities in this patient and describe how our management would differ from that of a similar, nonpregnant patient.

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Reference Intervals of Routine Coagulation Assays During the Pregnancy and Puerperium Period

Abstract: We presented reference intervals for coagulation assays from the nonpregnancy to puerperium period that can be adopted in other laboratories after further validation.

Cited by 27 publications

References 17 publications

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

To Clot or Not: HELLP Syndrome and Disseminated Intravascular Coagulation in an Eclamptic Patient with Intrauterine Fetal Demise

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