Analysis of influencing factors on blood coagulation composite indexes of maternal thromboelastography
LIU Xiao-hua1 LYU Zhi-ying2▲ OUYANG Lin2 ZHANG Zi-hui1 LI Yun1 ZHANG Ren-xiu1
1.Blood Bank, People′s Hospital of Xingguo County, Jiangxi Province, Xingguo 342400, China;
2.Clinical Laboratory, People′s Hospital of Xingguo County, Jiangxi Province, Xingguo 342400, China
Abstract：Objective To investigate the parameters of thromboelastic of pregnant women in different pregnancy periods and analyze the influencing factors of postpartum hemorrhage.Methods From January 2018 to February 2019, 128 pregnant women admitted to our hospital were selected as the pregnancy group.All the pregnant women had no pregnancy complications.Based on whether they had postpartum hemorrhage during delivery, pregnant women in the pregnancy group were divided into two groups, namely, the group without postpartum hemorrhage (90 cases) and the group with postpartum hemorrhage (38 cases).Moreover, 90 cases of pregnant women with different pregnancies who came to our hospital for pregnancy examination at the same time were selected for the study.According to their different gestational ages, they were divided into the early pregnancy group (n=30), the middle pregnancy group (n=30), and the late pregnancy group (n=30).Thirty non-pregnant healthy physical who came to our hospital at the same time for physical examination of antagonism were selected as the non-pregnant group.The related parameters of thromboelastogram, and the reference value of coagulation composite index of thromboelastogram in postpartum hemorrhage were tested.The coagulation function, thromboelastogram index were observed.The related factors affecting patients′ bleeding were analyzed and risk of each independent factor was performed with multi-factor regression analysis.Results In the pregnancy group, the thromboelastography indexes of the clotting time during the initial clotting phase (R value) and clot formation rate (K value) were lower than those in the non-pregnancy group, with statistically significant differences (P＜0.05).The thromboelastography indexes of fibrinogen function (Angle), platelet function (MA value) and comprehensive hemolysis index (CI value) of the pregnancy group were higher than those of the non-pregnancy group, with statistically significant differences (P＜0.05).The thromboelastography indexes of R value and K value in the late pregnancy group were lower than those in the middle pregnancy group and the early pregnancy group, and the differences were statistically significant (P＜0.05).The thromboelastography indexes of Angle, MA value and CI value in the late pregnancy group were higher than those in the middle pregnancy group and the early pregnancy group,with statistically significant differences (P＜0.05).The thromboelastography indexes of R value and K value in the middle pregnancy group were lower than those in the early pregnancy group, with statistically significant differences (P＜0.05).The thromboelastography indexes of Angle, MA value and CI value in the middle pregnancy group were higher than those in the early pregnancy group, with statistically significant differences (P＜0.05).The results of univariate analysis suggested that the thromboelastography indexes of R value and K value postpartum hemorrhage group were higher than those of the non-postpartum hemorrhage group, with statistically significant differences (P ＜0.05).The thromboelastography indexes of Angle and CI value in postpartum hemorrhage group were lower than those in the control group, with statistically significant differences (P＜0.05).The results of Logistic multivariate regression analysis suggested that the influencing factors for postpartum hemorrhage included the thromboelastography indexes of the R value(β=2.015, OR=13.853, 95% CI: 8.876-15.243), K value (β=1.304, OR=8.475, 95% CI: 6.765-10.974), Angle (β=0.742,OR=10.075, 95% CI: 7.391-12.341) and the CI value (β=1.839, OR=10.097, 95% CI: 8.492-13.473), the differences were statistically significant (P＜0.05).Conclusion According to the analysis of clinical data, there are significant differences in R value, K value, Angle, and CI value in the coagulation composite index of thromboelastogram for postpartum hemorrhage women compared with those without postpartum hemorrhage.The R value, K value, Angle, and CI value are influencing factors of postpartum hemorrhage.
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