An Assessment of the Effects on Coagulation of Midtrimester and Final-Trimester Amniotic Fluid on Whole Blood by Thrombelastograph® Analysis

Liu, Eugene H. C.; Shailaja, Suresh; Koh, Sau; Lee, Tat-Leang

doi:10.1097/00000539-200002000-00018

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…Harnett et al, 78 using thromboelastography analysis, have demonstrated that the addition of amniotic fluid to blood from pregnant women causes a hypercoagulable state related to the procoagulant activity of amniotic fluid and enhanced platelet activation, but there was no evidence of fibrinolysis, suggesting that the primary cause of bleeding in AFE is consumption coagulopathy. Similar results were reported by Liu et al, 79 using blood from non pregnant women.…”

Section: Resultssupporting

confidence: 91%

Amniotic fluid embolism: an evidence-based review

Conde-Agudelo

Romero

2009

American Journal of Obstetrics and Gynecology

240

277

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We conducted an evidence-based review of information bout amniotic fluid embolism (AFE). The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 13–30% and 9–44%, respectively. Risk factors associated with an increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical lacerations, and uterine rupture. The hemodynamic response in AFE is biphasic, with initial pulmonary hypertension and right ventricular failure, followed by left ventricular failure. Promising therapies include selective pulmonary vasodilators and recombinant activated facto Vlla. Important topics for future research are presented.

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Section: Resultssupporting

confidence: 91%

Amniotic fluid embolism: an evidence-based review

Conde-Agudelo

Romero

2009

American Journal of Obstetrics and Gynecology

240

277

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“…This substantiates the hypothesis that coagulation profile changes are invariable accompaniments of AFE [106]. The Thrombelastograph1 test may therefore be useful in assessing coagulopathy during or after AFE [107]. AF also contains large amounts of tissue factor (TF) pathway inhibitor (TFPI), accounting for virtually all of its coagulant potential.…”

Section: Pathophysiologysupporting

confidence: 72%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

European Respiratory Journal

161

127

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Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

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“…This technology has been used extensively in the monitoring of hemostasis during major surgical interventions such as liver transplantations [9,10], cardiovascular procedures [11][12][13][14][15], trauma [16] and neurosurgery [17,18]. It has also been used in the management of obstetrical complications [19][20][21] and of deep vein thrombosis [22] as well as in the monitoring of antagonists of platelet GPIIb/IIIa [23,24], platelet thromboxane A 2 and ADP [25], and recombinant Factor VIIa [26,27]. Its use has resulted in reduction in the use of blood products [9][10][11][12]15] during surgery, and in the rate of re-exploration in cardiac surgery [15].…”

mentioning

confidence: 99%

Evaluation of the profile of thrombin generation during the process of whole blood clotting as assessed by thrombelastography

Rivard

Brummel‐Ziedins

Mann

et al. 2005

Journal of Thrombosis and Haemostasis

197

151

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Thromboelastography is useful for assessment of whole blood coagulation. The objective of this study was to evaluate the possibility of linking the tracing of whole blood clotted in a thromboelastograph TEG with the generation of thrombin assessed by thrombin/antithrombin complex (TAT). Citrated whole blood containing corn trypsin inhibitor from volunteers was clotted in the presence of CaCl 2 and tissue factor. Clotting was monitored with 8 channels of a TEG system. At different time points the whole blood TEG reaction cups were put in a cold quenching solution, centrifuged, and the supernatants were kept at −80°C until assayed for TAT by ELISA. Total Thrombus Generation (TTG) was calculated from the first derivative of the TEG waveform and was compared to thrombin generation measured by TAT. The two vectors of values -the TAT thrombin generation data and the corresponding TEG TTG -were analyzed using Pearson correlation coefficients and linear, non-linear, and natural log (Ln) transformation of TAT values for leastsquares goodness-of-fit curves. The best least-squares fit is an exponential curve. Linearizing using the natural log of the TAT thrombin generation variable produces the same R 2 as for the exponential curve. The prediction equation is y = 8.0465 + 0.0005x (P≤ 0.0001), where y is the TAT thrombin generation in the Ln transformation variable and x is the TEG TTG variable. The high magnitude of R 2 and the high significance of the prediction equation demonstrate the high efficacy of the prediction of TAT thrombin generation using the TEG TTG.

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An Assessment of the Effects on Coagulation of Midtrimester and Final-Trimester Amniotic Fluid on Whole Blood by Thrombelastograph® Analysis

Cited by 11 publications

References 10 publications

Amniotic fluid embolism: an evidence-based review

Amniotic fluid embolism: an evidence-based review

Nonthrombotic pulmonary embolism

Evaluation of the profile of thrombin generation during the process of whole blood clotting as assessed by thrombelastography

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