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Role of Thromboelastography Versus Coagulation Screen as a Safety Predictor in Pre-eclampsia/Eclampsia Patients Undergoing Lower-Segment Caesarean Section in Regional Anaesthesia

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Abstract

Purpose

In this study, we aimed to correlate thromboelastography (TEG) variables versus conventional coagulation profile in all patients presenting with pre-eclampsia/eclampsia and to see whether TEG would be helpful for evaluating coagulation in parturients before regional anaesthesia.

Materials and Methods

This was a prospective study on 100 pre-eclampsia/eclampsia patients undergoing lower-segment caesarean section under regional anaesthesia. Two blood samples were collected. First sample was used for TEG measurement and second sample for laboratory tests. The following TEG data were obtained—reaction time, kinetic time, alpha angle, and maximum amplitude (MA). The following laboratory tests were obtained—haematology (haemoglobin, TLC, DLC, platelet count) and coagulation test [prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT)].

Result

Out of 100 patients enrolled in the study, 80 (80 %) had a normal coagulation profile, while remaining 20 (20 %) had hypocoagulation profile. The results show that TEG parameters have a good correlation with conventional coagulation profile and also showed excellent independent predictive efficacy for prediction of hypocoagulation. PT, aPTT, and TT were directly proportional to R-time and K-time and inversely proportional to alpha angle (p < 0.001). Platelet count showed a strong positive correlation with MA (p < 0.001).

Conclusion

By giving a global picture of haemostasis, TEG can lead to improved decision-making about safety of using regional anaesthesia. Its fast feedback time makes it ideal for monitoring in a fast moving situation such as in obstetric emergency.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, T. S. Mishra Medical College and Hospital, Haleem Manor, Flat No.-401, 179/19, Baroodkhana, Golaganj, Lucknow, 226018, India

    Asrar Ahmad

  2. Department of Anesthesiology and Critical Care, King George’s Medical University, Lucknow, India

    Monica Kohli, Anita Malik, Jaishri Bogra, Haider Abbas, Rajni Gupta & B. B. Kushwaha

  3. Department of Anesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India

    Megha Kohli

Authors
  1. Asrar Ahmad
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  2. Monica Kohli
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  3. Anita Malik
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  4. Megha Kohli
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  5. Jaishri Bogra
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  6. Haider Abbas
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  7. Rajni Gupta
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  8. B. B. Kushwaha
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Corresponding author

Correspondence to Asrar Ahmad.

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Conflict of interest

Dr. Monica Kohli, Dr. Anita Malik, Dr. Megha Kohli, Dr. Jaishri Bogra, Dr. Haider Abbas, Dr. Rajni Gupta, Dr. B. B. Kushwaha declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national).

Additional information

Dr. Asrar Ahmad M.D. (Anesthesiology), Assistant Professor, T. S. Mishra Medical College and Hospital; Prof. Monica Kohli M.D. (Anesthesiology), PDCC, Professor, King George’s Medical University; Prof. Anita Malik M.D. (Anesthesiology), Professor, King George’s Medical University; Dr. Megha Kohli, Junior Resident 3 (Anesthesiology and Intensive Care), Maulana Azad Medical College; Prof. Jaishri Bogra D.A., M.D. (Anesthesiology), Professor, King George’s Medical University; Prof. Haider Abbas M.D. (Anesthesiology), Professor, King George’s Medical University; Prof. Rajni Gupta M.D. (Anesthesiology), Professor, King George’s Medical University; Dr. B. B. Kushwaha M.D. (Anesthesiology), Associate Professor, King George’s Medical University.

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Ahmad, A., Kohli, M., Malik, A. et al. Role of Thromboelastography Versus Coagulation Screen as a Safety Predictor in Pre-eclampsia/Eclampsia Patients Undergoing Lower-Segment Caesarean Section in Regional Anaesthesia. J Obstet Gynecol India 66 (Suppl 1), 340–346 (2016). https://doi.org/10.1007/s13224-016-0906-y

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  • DOI: https://doi.org/10.1007/s13224-016-0906-y

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