VPB1427 - The use of rotational thromboelastometry in the management of thromboprophylaxis in pregnancy

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Kristína Vajdová, MD, PhD.

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Co-Author(s)

MD

Miroslava Dobrotová

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PH

Pavol Holly

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Jana Zolkova, DSc, PhD

laboratory researcher
National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Slovakia
Martin, Zilina, Slovakia
�V

Ľubica Vadelová

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia 2Center of Hemostasis and Thrombosis - Unilabs Slovakia, s. r. o., Martin, Slovakia
Martin, Zilina, Slovakia
IS

Ingrid Skornova

Laboratory diagnostician
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JI

Jela Ivanková

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Monika Brunclikova, MD

physician
National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Slovakia
Martin, Zilina, Slovakia
MG

Marian Grendar

biostatistician
Biomedical Center Martin, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin
Martin, Zilina, Slovakia
JD

Ján Danko

university professor
Department of Gynecology and Obstetrics, Comenius University In Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PK

Peter Kubisz

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JS

Jan Stasko

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Background: Anticoagulant thromboprophylaxis with low-molecular-weight heparin (LMWH) for patients with a previous venous thromboembolism (VTE) is recommended. There are only limited cases of its use in the prevention of thrombotic complications in pregnancy.

Aims: The authors present the results of a prospective and longitudinal study of haemostasis in at-risk pregnant patients.

Methods: Blood samples were taken at these time points: T1 during the 10th–12th week of pregnancy (WP), T2 in the 16th–18th WP, T3 between the 26th–28th WP, T4 in the 35th–36th WP and T5 between the 6th–8th week following the delivery.
Results of clotting time (CT), clot formation time (CFT), alpha angle (AA) and maximum clot firmness (MCF) were compared between T1–T4 and T5 when selected parameters are expected to be normalized. The authors also compared the results with the data of the control group.
Written informed consent of included patients was obtained and the study was approved by the Ethics committee of the Jessenius Faculty of Medicine. Study complies with the Declaration of Helsinki. The authors do not have any conflict of interest.

Results: The authors observed shortening of CFT in EXTEM (p 0.0007 from the 26th WP vs. control group) and INTEM (p 0.002 from the 35th WP), increase in AA in EXTEM, INTEM, and HEPTEM, and the persistent increase in MCF in all three mentioned tests. According to the results, LMWH dose was modified in particular patients.

Conclusion(s): Even after the postpartum period, AA in EXTEM was steeper when comparing with the control group (p 0.0007). This may indicate that haemostasis is not completely normalized after 6–8 weeks after delivery.
ROTEM seems to be a helpful tool for the individual assessment of the termination of secondary thromboprophylaxis.
Acknowledgement: The authors thank the support of projects of the Agency for the Support of Research and Development APVV-16-0020 and Scientific Grant Agency 1/0549/19.