• Gestational coagulopathy: breakthrough in views on prevention of bleeding

Gestational coagulopathy: breakthrough in views on prevention of bleeding

HEALTH OF WOMAN. 2017.7(123):40–46; doi 10.15574/HW.2017.123.40

Makarenko M., Govsieiev D., Sokol I., Slobodenyuk A., Berestovoy V., Vorona R.
A.A. Bogomolets National Medical University, Kiev

Nowadays, for understanding the mechanisms of hemostasis used the «cascade» (the waterfall) model for process of blood clotting. From the end of the 19th century, scientists have been trying to unravel the mechanism of blood clotting, simulate hemostasis. Attempts to assess the system as a whole, as a single functioning complex, led to a method, known as, thromboelastography (TEG).
The objective: examine the value of the TEG in prevention of bleeding in pregnant with a low level of platelets.
Patients and methods. Аnalysis of pregnant women during the third trimester with a level of platelets below 150*109/l was done. All women tested with TEG method. The main group (MG) consist of 91 woman with changes in the hemostasis system. MG randomly divided into 2 subgroups. In the I subgroup 48 women received infusion of blood components. In the II subgroup 43 women without correction in system of hemostasis. The control group (CG) consist of 44 women with platelet level more than 150*109/l, without pathological changes according to TEG.
Results. Comparison of blood loss during childbirth and cesarean section in subgroup I and II, as well as in CG, demonstrates less blood loss I subgroup in comparison with II subgroup (p < 0.05). Smallest blood loss noted in CG compared to the MG (p<0.05).
Conclusions. 1. Our research shows the value of the TEG in bleeding prevention in women with low levels of platelets. In general, TEG method shows the overall status of the hemostatic system in vivo. 2.Determination of indicators of the hemostatic system is extremely important, especially in cases where it expected to «mandatory» blood loss during childbirth, surgeries etc. Proper correction hemostatic changes based on TEG data helps to prevent the development of massive bleeding.
Key words: thromboelastography, obstetric hemorrhage, thrombocytopenia, hemostasis.


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