Thromboelastometry during Labor and after Delivery

The normal values of thromboelastometry (MonoTEM-A&174, Framar Hemologix) in pregnancy have not been determined. The aim of this study was to establish the reference ranges for the thromboelastometer in healthy pregnant women during labor and after delivery. After ethical institutional approval and informed consent, we collected blood samples for analysis from 95 healthy labouring women and 40 volunteers (non pregnant women, control group). A sample of 360 μL of whole native blood was tested using the MonoTEM-A&174 equipment and analyzed within 4 min, at 37℃. We recorded: R = time to initial fibrin formation; K = time to initial clot formation; Alpha Angle = acceleration of clot formation and MA = strength of the blood clot. When compared to the control group, R and K values were lower in women during labor and after the delivery. The Alpha angle and MA values were higher in the laboring women and in the same women after delivery as compared to the control group. Our study determined the reference ranges for the MonoTEM-A&174 in pregnancy during labor and immediately after the delivery. Data obtained from thromboelastometry confirm the hypercoagulability status in pregnancy and the puerperium. MonoTEM-A&174 thromboelastometry may be a very useful tool to assess the clotting activity in this patient setting.