The Diagnostic Efficacy of Thrombelastography (TEG) in Patients with Preeclampsia and its Association with Blood Coagulation

血栓弹力图(TEG)在先兆子痫患者诊断中的效能及其与血液凝固的关系

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Abstract

OBJECTIVE: The aim of this study was to investigate the diagnostic efficacy of thrombelastography (TEG) in patients with preeclampsia. METHODS: One hundred and seventeen pregnant women were recruited from Department of Obstetrics and Gynecology of 1(st) affiliated Hospital of Fujian Medical University. Of the 117 patients, 59 were normal late gestation (control group), 32 were mild preeclampsia and other 26 cases were severe preeclampsia. All the patients were received thrombelastography (including: K time, Reaction time, Clot angel, MA value, CI value) and blood coagulation examination (including: PT, APTT, Fib, TT, D-dimer and AT-III). RESULTS: The R time, K time, Coagulation Index value and Clot Angle in preeclampsia group were significant different between control and preeclampsia groups with statistical difference (p<0.05). Moreover, the R and K time value in severe preeclampsia group were significant higher than those of control groups (p<0.05); however, the Coagulation Index value and Clot Angle in severe preeclampsia group were significant higher than those of mild preeclampsia group with statistical difference (p<0.05). Coagulation Index had the highest diagnostic sensitivity [87.93 (76.70-95.01) %] and specificity [83.83 (79.17-96.18)%] compared to other parameters with the AUC of 0.94 (0.90-0.98). The K time and the Coagulation Index had the highest diagnostic sensitivity (96.15%) and specificity (0.75%) respectively with the AUC of 0.68 and 0.75 respectively in differential diagnosis of severe preeclampsia from mild preeclampsia. However, there were no statistical difference in the aspects of platelet count and parameters relevant to coagulation test for the control, mild and sever preeclampsia groups(p>0.05). CONCLUSION: TEG provides more accurate information in monitoring the blood coagulation of preeclampsia patients and can be used as a reliable marker for assessing the severity of preeclampsia.

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