Abstract
BACKGROUND: Pregnancy induces a hypercoagulable state to prevent hemorrhage during delivery, but it also increases the risk of thrombotic events and postpartum hemorrhage. Monitoring coagulation changes is essential to ensure maternal and fetal health. Thromboelastography (TEG), which provides a detailed assessment of the coagulation cascade, remains underutilized across all stages of pregnancy. METHODS: This retrospective study included 92 pregnant women grouped by trimester (30 in the first, 34 in the second, and 28 in the third), and 30 non-pregnant women as controls. Standard coagulation metrics [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB)] and TEG parameters (R, K, α-angle, MA) were measured and compared. RESULTS: As pregnancy progressed, PT, APTT, and TT decreased, while Fibrinogen levels increased significantly compared to the control group (p < 0.05). TEG results showed a decrease in R and K values, with an increase in α-angle and MA across trimesters (p < 0.05). ROC analysis showed that combining TEG with traditional tests improved the accuracy of assessing coagulation status, yielding an AUC of 0.876, sensitivity of 84.0%, and specificity of 83.6%. CONCLUSION: Significant changes in both TEG and traditional coagulation parameters throughout pregnancy reflect the development of a hypercoagulable state. The integration of TEG with standard tests offers a comprehensive approach for detecting coagulation abnormalities early, improving perinatal outcomes. These findings are descriptive of physiological adaptation and do not support routine TEG screening in healthy pregnancies.