PB0466 - Comparison of coagulation profile amongst Normotensive pregnancy and Pre-eclampsia patients and its impact on maternal outcome

Background: Pregnancy is a prothrombotic state characterized by increase in thrombin and procoagulant factors. Preeclampsia is a syndrome affecting 3–5% of pregnancies; diagnosed with elevated blood pressure, proteinuria and maternal organ dysfunction/fetal growth restriction. Excessive activation of coagulation with increased platelet activation and deposition of fibrin degradation products in the placenta leading to endothelial damage is observed in Preeclampsia.

Aims: To compare the coagulation profile and maternal outcome amongst normotensive pregnant and pre-eclampsia patients

Methods: Study Design Cross Sectional Study

Study Setting Department Of Transfusion Medicine in collaboration with department Of Obstetrics And Gynaecology ,Jubilee Mission Medical College Research Institute

Study Period April - June 2023.

Study Population Pregnant women admitted for delivery

Exclusion criteria Pregnant women with GDM, Bleeding disorders, Pre existing Liver and Kidney disease

METHODOLOGY

All pregnant women admitted for delivery were selected and divided into two groups – normotensive and pre-eclampsia.

Data were obtained from medical records and hospital information systems.

Tests included a complete hemogram, PT/INR, aPTT.

Maternal outcome was assessed using gestational age and mode of delivery, duration of hospitalization and transfusion requirements

Results: A total of 68 cases-48(70.58%) normotensive and 20(29.4%) pre-eclampsia were recruited. No statistical difference could be seen in hemoglobin, red cell & white cell parameters. In preeclamptic patients(n=20) thrombocytopenia (30%), Prolonged PT /INR & aPTT (20%), preterm delivery (35%), prolonged postpartum hospitalization (25%), DIC (20%), HELLP syndrome (5%) and pulmonary oedema (5%) were observed. Transfusions were given to 15% patients with DIC.

Conclusion(s): Study found a higher risk of coagulopathy in preeclampsia compared to normotensive pregnancy.

Thrombocytopenia and prolonged aPTT indicates need for early management and peripartum monitoring.

Prevention of seizures with magnesium sulphate, reversal of coagulopathy by transfusion and timely delivery of foetus continues to be the main pillars of management