Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia.
Coagulation
Elective caesarean deliveries
Pregnancy
ROTEM®
Reference ranges
Rotational thromboelastometry
Third trimester
Journal
International journal of obstetric anesthesia
ISSN: 1532-3374
Titre abrégé: Int J Obstet Anesth
Pays: Netherlands
ID NLM: 9200430
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
13
09
2018
revised:
20
12
2018
accepted:
11
01
2019
pubmed:
17
2
2019
medline:
21
1
2020
entrez:
17
2
2019
Statut:
ppublish
Résumé
Formal reference ranges for rotational thromboelastometry (ROTEM®) in pregnancy have not been obtained in the recommended minimum sample size of 120. This prospective observational study aimed to establish baseline parameters in an Australian population of women undergoing elective caesarean delivery. The secondary aim was to compare these reference ranges with those from prior studies and the manufacturer. Women undergoing elective caesarean delivery at term were included if they were at term, of normal body mass index and had no conditions affecting coagulation. ROTEM® reference ranges were derived by calculating the 2.5 and 97.5 percentiles for INTEM/EXTEM/FIBTEM amplitude at 5 minutes (A5), amplitude at 15 minutes (A15), coagulation time (CT), maximum clot firmness (MCF), and clot formation time (CFT). Of 202 women screened, 132 met the inclusion criteria, having a mean age of 32.7 ± 5.0 years and median body mass index of 23.8 kg/m ROTEM® reference ranges for women with uncomplicated term pregnancies were reported as per the International Federation of Clinical Chemistry. The FIBTEM MCF and FIBTEM/EXTEM/INTEM amplitudes were higher in comparison to the manufacturer's reference ranges for the non-obstetric population. The EXTEM CT was shorter than the non-obstetric reference ranges. These ranges show an increase in coagulability during normal pregnancy compared to the non-pregnant reference ranges.
Sections du résumé
BACKGROUND
Formal reference ranges for rotational thromboelastometry (ROTEM®) in pregnancy have not been obtained in the recommended minimum sample size of 120. This prospective observational study aimed to establish baseline parameters in an Australian population of women undergoing elective caesarean delivery. The secondary aim was to compare these reference ranges with those from prior studies and the manufacturer.
METHODS
Women undergoing elective caesarean delivery at term were included if they were at term, of normal body mass index and had no conditions affecting coagulation. ROTEM® reference ranges were derived by calculating the 2.5 and 97.5 percentiles for INTEM/EXTEM/FIBTEM amplitude at 5 minutes (A5), amplitude at 15 minutes (A15), coagulation time (CT), maximum clot firmness (MCF), and clot formation time (CFT).
RESULTS
Of 202 women screened, 132 met the inclusion criteria, having a mean age of 32.7 ± 5.0 years and median body mass index of 23.8 kg/m
CONCLUSIONS
ROTEM® reference ranges for women with uncomplicated term pregnancies were reported as per the International Federation of Clinical Chemistry. The FIBTEM MCF and FIBTEM/EXTEM/INTEM amplitudes were higher in comparison to the manufacturer's reference ranges for the non-obstetric population. The EXTEM CT was shorter than the non-obstetric reference ranges. These ranges show an increase in coagulability during normal pregnancy compared to the non-pregnant reference ranges.
Identifiants
pubmed: 30770209
pii: S0959-289X(18)30436-9
doi: 10.1016/j.ijoa.2019.01.008
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
10-18Commentaires et corrections
Type : CommentIn
Informations de copyright
Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.