Assessment of Platelet Function Using Modified Thromboelastography in Women with Severe Preeclampsia and Thrombocytopenia

Gottumukkala, Vijaya; Sharma, Swati; Philip, Jean-Luc; Pérez, Beatriz Martín; Wiley, Jackie; Whitten, Charles W.; Landers, Dennis F.

doi:10.1097/00000542-199904001-00002

Cited by 4 publications

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“…The monoclonal antibody fragment c7E3 Fab (ReoPro ® ), by binding to platelet surface fibrinogen receptors (glycoprotein, GPIIb/IIIa), inhibits platelet aggregation and its interaction with fibrinogen. Thromboelastography with ReoPro ® (modified thromboelastography) has been used to evaluate platelet function (5,6).…”

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confidence: 99%

Assessing Platelet and Fibrinogen Contribution to Clot Strength Using Modified Thromboelastography in Pregnant Women

Gottumukkala

Sharma

Philip

1999

Anesthesia &Amp; Analgesia

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The monoclonal antibody fragment c7E3 Fab (ReoPro ® ), by binding to platelet surface fibrinogen receptors (glycoprotein, GPIIb/IIIa), inhibits platelet aggregation and its interaction with fibrinogen. In this study, we used thromboelastography with ReoPro ® to evaluate the independent contribution of fibrinogen and platelets to clot strength. Thromboelastography was performed in 21 healthy, term parturients scheduled for elective cesarean delivery with 360 L of celite-activated whole blood and with 5 L of (2 mg/mL) ReoPro ® added to 355 L of celite-activated whole blood. The contribution of platelets to clot strength (MAplt) was derived by subtracting MAfib (maximal amplitude with ReoPro ® ) from MAwb (maximal amplitude with whole blood). Thus, MAwb Ϫ MAfib ϭ MAplt. The value for MAwb (mean Ϯ sd) was 73 Ϯ 4 mm, for MAfib it was 33 Ϯ 5 mm, and for MAplt it was 40 Ϯ 3 mm. The contribution of fibrinogen and platelets to the MAplt was 45% and 55%, respectively. Modified thromboelastography using ReoPro ® in healthy parturients can be used to determine the contribution of fibrinogen and platelets to blood clot strength. Implications: Determining the independent contribution of platelets and fibrinogen to the maximal amplitude of thromboelastography using c7E3 Fab may further improve the use of thromboelastography in detecting and treating coagulation defects.

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confidence: 99%

Assessing Platelet and Fibrinogen Contribution to Clot Strength Using Modified Thromboelastography in Pregnant Women

Gottumukkala

Sharma

Philip

1999

Anesthesia &Amp; Analgesia

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The Anticoagulated Patient

Sharma¹,

Leveno²

Anesthetic and Obstetric Management of High-Risk Pregnancy

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In Vitro Fertilization-Induced Alterations in Coagulation and Fibrinolysis as Measured by Thromboelastography

Harnett

Bhavani-Shankar²,

Datta³

et al. 2002

Anesthesia & Analgesia

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Supraphysiologic increases in estrogen produced by in vitro fertilization (IVF) promote the expression of hemostatic markers. Although quantitative studies of individual markers have been performed during IVF, their results are conflicting and do not reveal the qualitative effect of each marker on the overall coagulation and fibrinolytic processes. Thrombelastograph (TEG) coagulation analysis, by contrast, provides a global measure of coagulation and fibrinolysis and can indicate the relative contributions of clotting factors, fibrinogen, and platelets to each process. We studied the serum estrogen concentrations and TEG variables in 24 women at the beginning and conclusion of an IVF stimulation cycle. Serum estradiol (E(2)) concentrations (mean +/- SD) increased from 26.9 +/- 8.6 to 2098 +/- 913 pg/mL (P < 0.005) at baseline and oocyte retrieval, respectively. The measured TEG indices demonstrated alterations in coagulation rather than fibrinolysis. Although significant changes were noted in both the clot formation time and the coagulation index (P < 0.005), all TEG values remained within the normal range. In addition, an increased role of fibrinogen in promoting clot strength was observed. These findings may assist in the treatment of IVF patients who ultimately develop thromboembolic complications as a result of ovarian hyperstimulation. IMPLICATIONS. The dramatic changes in estrogen produced by in vitro fertilization therapies result in hemostatic marker alterations. Thrombelastograph coagulation analysis, which provides a global assessment of these changes, demonstrated significant alterations in two coagulation indices (clot formation time, coagulation index), although all variables remained within normal limits. The relative importance of fibrinogen versus platelets in determining clot strength was observed. No significant alterations in fibrinolysis were detected.

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Assessment of Platelet Function Using Modified Thromboelastography in Women with Severe Preeclampsia and Thrombocytopenia

Cited by 4 publications

References 0 publications

Assessing Platelet and Fibrinogen Contribution to Clot Strength Using Modified Thromboelastography in Pregnant Women

Assessing Platelet and Fibrinogen Contribution to Clot Strength Using Modified Thromboelastography in Pregnant Women

The Anticoagulated Patient

In Vitro Fertilization-Induced Alterations in Coagulation and Fibrinolysis as Measured by Thromboelastography

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