Associations of thrombocytopenia, transaminase elevations, and transfusion with laboratory coagulation tests in women with preeclampsia: a cross-sectional study.
Associations of thrombocytopenia, transaminase elevations, and transfusion with laboratory coagulation tests in women with preeclampsia: a cross-sectional study.
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DOI：
10.1016/j.ijoa.2021.102972
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发表时间：
2021-05
影响因子：
2.8
通讯作者：
Bateman BT
中科院分区：
文献类型：
--
作者：
Combs DJ;Gray KJ;Schulman S;Bateman BT
妇女先兆子痫可能发展凝血功能障碍，易出血并发症。尽管指南和先前的研究相冲突，但我们假设在子痫前期，凝血试验结果异常在血小板减少症或转氨酶升高的女性中更常见，并增加输血风险。我们的目标是调查：1。凝血试验模式；2. 血小板计数、转氨酶水平与凝血试验异常风险的关系3. 出血并发症的风险；和4。凝血参数明显异常患者的特点。方法：对1994年至2018年间在两家医院之一接受活化部分凝血活素时间（aPTT）或国际标准化比率（INR）检测的先兆子痫妇女的分娩进行横断面研究。在10699名先兆子痫妇女中，3359名（32.7%）进行了凝血试验，124名（3.7%）出现aPTT或INR升高。凝血功能异常在有血小板减少症或转氨酶升高的女性（n=82）中比无转氨酶升高的女性（n=42）更常见（6.7%,95% CI 5.5 ~ 8.2 vs 1.8%, 95% CI 1.3 ~ 2.5）。凝血参数异常的女性（n=124）比无凝血参数异常的女性（n=39）输血更常见（33.1% vs 7.0%, P <0.001）。在26例aPTT≥40 s或INR≥1.4的患者中，6例需要输血（均有胎盘早剥和弥散性血管内凝血功能障碍）。在这个队列中，凝血试验的执行不一致。血小板计数和转氨酶水平不能充分检测异常凝血试验结果。凝血试验结果异常与红细胞输血风险显著增高有关。
Women with pre-eclampsia may develop coagulopathy, predisposing to bleeding complications. Although guidelines and prior studies conflict, we hypothesized that in preeclampsia, abnormal coagulation test results are more common in women with thrombocytopenia or transaminase elevations and increase the transfusion risk. Our objectives were to investigate: 1. patterns of coagulation testing; 2. relationships between platelet count, transaminase level, and the risk of abnormal coagulation tests; 3. risk of bleeding complications; and 4. characteristics of patients with markedly abnormal coagulation parameters. Methods: A cross-sectional study of deliveries of women with preeclampsia who had undergone activated partial thromboplastin time (aPTT) or international normalized ratio (INR) testing at one of two hospitals between 1994 and 2018. Of 10 699 women with preeclampsia, 3359 (32.7%) had coagulation testing performed and aPTT or INR elevations were present in 124 (3.7 %). Coagulation abnormalities were more common in women with thrombocytopenia or transaminase elevations (n=82) compared with those without (n=42) (6.7%, 95% CI 5.5 to 8.2 vs 1.8%, 95% CI 1.3 to 2.5). Transfusion was more common among women with abnormal coagulation parameters (n=124) compared with those without (n=39) (33.1 vs 7.0%, P <0.001). Among 26 patients with an aPTT ≥40 s or an INR ≥1.4, six required transfusion (all had placental abruption and disseminated intravascular coagulopathy). Coagulation testing was inconsistently performed in this cohort. Platelet counts and transaminase levels inadequately detected abnormal coagulation test results. Abnormal coagulation test results were associated with a markedly higher risk for red blood cell transfusion.
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影响因子：
8.8
作者：
Hawkins, JL;Koonin, LM;Gibbs, CP
通讯作者：
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DOI：
10.1111/ajo.12399
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