The Impact of Prepartum Platelet Count on Postpartum Blood Loss and Its Association with Coagulation Factor XIII Activity.
Factor XIII
Platelet transfusion
Platelets
Postpartum hemorrhage
Thrombocytopenia
Journal
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie
ISSN: 1660-3796
Titre abrégé: Transfus Med Hemother
Pays: Switzerland
ID NLM: 101176417
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
05
07
2022
accepted:
03
01
2023
entrez:
23
2
2023
pubmed:
24
2
2023
medline:
24
2
2023
Statut:
epublish
Résumé
Postpartum hemorrhage is a leading cause of maternal morbidity and mortality worldwide. Contradictory information exists regarding the relevance of prepartum platelet count on postpartum hemorrhage. We have shown prepartum coagulation factor XIII to be associated with postpartum blood loss; however, little is known about the association of platelet count with factor XIII activity. Our objectives were, first, to evaluate the impact of prepartum platelet count on measured postpartum blood loss in the context of prepartum measurements of coagulation factors I, II, and XIII and, second, to evaluate the association of platelet count with coagulation factor XIII, both pre- and postpartum. This is a secondary analysis of a prospective cohort study (PPH 1,300 study) which analyzed the impact of prepartum blood coagulation factors on postpartum blood loss in 1,300 women. Blood loss was quantified using a validated technique. The impact of prepartum platelet count on measured blood loss was assessed by continuous outcome logistic regression; the association of platelet count with factor XIII activity by Spearman rank correlation. Prepartum platelet count was significantly associated with measured postpartum blood loss: every one unit (G/L) increase in prepartum thrombocytes was associated with an odds ratio of 1.002 (95% confidence interval, 1.001-1.004, The significant association of prepartum platelet count and postpartum blood loss as well as the association of platelet count with blood coagulation factor XIII activity support the likely role of platelets in preventing postpartum hemorrhage and support the new guidelines for the treatment of postpartum hemorrhage in Germany, Austria, and Switzerland, which calls for optimizing platelet counts peripartally in case of postpartum hemorrhage. A possible effect of platelets on the level of circulating factor XIII cannot be ruled out and should prompt further investigation.
Sections du résumé
Background
UNASSIGNED
Postpartum hemorrhage is a leading cause of maternal morbidity and mortality worldwide. Contradictory information exists regarding the relevance of prepartum platelet count on postpartum hemorrhage. We have shown prepartum coagulation factor XIII to be associated with postpartum blood loss; however, little is known about the association of platelet count with factor XIII activity. Our objectives were, first, to evaluate the impact of prepartum platelet count on measured postpartum blood loss in the context of prepartum measurements of coagulation factors I, II, and XIII and, second, to evaluate the association of platelet count with coagulation factor XIII, both pre- and postpartum.
Material and Methods
UNASSIGNED
This is a secondary analysis of a prospective cohort study (PPH 1,300 study) which analyzed the impact of prepartum blood coagulation factors on postpartum blood loss in 1,300 women. Blood loss was quantified using a validated technique. The impact of prepartum platelet count on measured blood loss was assessed by continuous outcome logistic regression; the association of platelet count with factor XIII activity by Spearman rank correlation.
Results
UNASSIGNED
Prepartum platelet count was significantly associated with measured postpartum blood loss: every one unit (G/L) increase in prepartum thrombocytes was associated with an odds ratio of 1.002 (95% confidence interval, 1.001-1.004,
Discussion/Conclusion
UNASSIGNED
The significant association of prepartum platelet count and postpartum blood loss as well as the association of platelet count with blood coagulation factor XIII activity support the likely role of platelets in preventing postpartum hemorrhage and support the new guidelines for the treatment of postpartum hemorrhage in Germany, Austria, and Switzerland, which calls for optimizing platelet counts peripartally in case of postpartum hemorrhage. A possible effect of platelets on the level of circulating factor XIII cannot be ruled out and should prompt further investigation.
Identifiants
pubmed: 36818769
doi: 10.1159/000529020
pii: tmh-0050-0002
pmc: PMC9911997
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2-9Informations de copyright
Copyright © 2023 by The Author(s). Published by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The Center for Laboratory Medicine (Z.L.M.) St. Gallen holds patents on the point of care diagnostics of factor XIII. One of the authors of this manuscript (W.K.) is one of the authors of the new guideline.
Références
Arch Gynecol Obstet. 2019 Feb;299(2):421-430
pubmed: 30511192
Arch Gynecol Obstet. 2018 Dec;298(6):1071-1077
pubmed: 30225686
J Thromb Haemost. 2007 Feb;5(2):266-73
pubmed: 17087729
Int J Gynaecol Obstet. 2021 Apr;153(1):89-94
pubmed: 33341932
Anesth Analg. 2017 Jan;124(1):277-281
pubmed: 27749352
Eur J Anaesthesiol. 2017 Jun;34(6):332-395
pubmed: 28459785
F1000Res. 2017 Nov 1;6:1933
pubmed: 29259768
J Clin Med. 2020 Jul 31;9(8):
pubmed: 32751988
J Thromb Haemost. 2020 Jun;18(6):1310-1319
pubmed: 32176833
Anesthesiology. 2009 Feb;110(2):239-45
pubmed: 19194150
Geburtshilfe Frauenheilkd. 2018 Apr;78(4):382-399
pubmed: 29720744
Int J Mol Sci. 2021 Mar 17;22(6):
pubmed: 33802692
Surg Neurol. 2000 Sep;54(3):260-4; discussion 264-5
pubmed: 11118574
Transfusion. 2014 Jul;54(7):1756-68
pubmed: 24617726
Am J Perinatol. 2017 Sep;34(11):1135-1141
pubmed: 28683512
Physiol Rev. 2011 Jul;91(3):931-72
pubmed: 21742792
Obstet Gynecol. 2020 Jun;135(6):1338-1344
pubmed: 32459425
Thromb Res. 2014 Sep;134(3):750-2
pubmed: 25053372
Br J Anaesth. 2012 Dec;109(6):851-63
pubmed: 23075633
Transfus Med Rev. 2018 Oct;32(4):225-229
pubmed: 30177431
Transfus Med Hemother. 2017 Apr;44(2):85-92
pubmed: 28503124
Obstet Gynecol. 2017 Oct;130(4):e168-e186
pubmed: 28937571
Stat Med. 2017 Nov 30;36(27):4316-4335
pubmed: 28872693
J Crit Care. 2020 Apr;56:18-25
pubmed: 31805464
Am J Obstet Gynecol MFM. 2021 Jul;3(4):100368
pubmed: 33831587