Use of thromboelastography to assess the combined role of pregnancy and obesity on coagulation: a prospective study

Changes in thromboelastography parameters in pregnancy, labor, and the immediate postpartum period

“…A previous study [5] looking at one sample timepoint has confirmed the hypercoaguable status of women at term through thromboelastography analysis. Similarly, a shift toward hypercoagulability as measured by thromboelastography [6] and rotational thromboelastometry [7] has been reported in uncomplicated pregnancies as pregnancy advances.…”

An observational study of haemostatic changes, leptin and soluble endoglin during pregnancy in women with different BMIs

“…Sharma et al study [17] found the coagulation index was significantly higher in both obese mothers and nonpregnant women compared with the nonobese groups but that there were no differences between the pregnant and nonpregnant groups when matched for BMI. In agreement with our results, Sharma Results are means AE standard deviation.…”

“…Recently, Sharma et al [17] published work, investigating TEG in pregnant and nonpregnant lean and obese groups. They demonstrated an increased coagulation index in both obese groups compared with lean groups (nonpregnant lean À4.5 versus nonpregnant obese 1.9, P < 0.001; pregnant lean À4.3 versus pregnant obese 2.5, P < 0.001) but found no significant difference in prothrombin time (PT) or activated partial thromboplastin time (APTT) between groups [17]. We have not found any research looking at specific tests of activation of coagulation and fibrinolysis in pregnant women of varying BMI.…”

Using antifibrinolytics in the peripartum period – concern for a hypercoagulable effect?

“…Eligible pregnant women were prospectively divided into three groups: 1) healthy pregnant women, 2) obese pregnant women and 3) pregnant women with preeclampsia. Obesity was defined as a maternal body mass index (BMI) of greater than 35.0 kg/m 2 at the time of enrollment and was selected based on a prior study showing viscoelastic evidence of hypercoagulability in obese pregnant women [12]. Preeclampsia was defined by blood pressure >140/90 and proteinuria >300 mg on 24 urine collection or protein/creatinine ratio.…”

“…Specifically, obese women have a hypercoagulable profile that put them at increased risk for venous thromboembolism [11,12], and women with preeclampsia display altered coagulation parameters [13]. We tested our hypothesis that anti-fibrinolytic drugs do not increase hypercoagulability in pregnancy by comparing ROTEM parameters before and after the addition of TXA and EACA to whole blood samples from healthy pregnant and non-pregnant women, obese pregnant women, and preeclamptic pregnant women.…”