PB0180 - Compensatory effect of fibrinogen in pregnant patients with thrombocytopenia

Background: This study explores the compensatory effect of fibrinogen on clot strength in thrombocytopenic pregnant women using Thromboelastometry (TEG). We believe that our study makes a significant contribution to the literature because it suggests that elevated fibrinogen levels may offset reduced clot strength in thrombocytopenia, potentially offering an alternative to platelet transfusion

Aims: Platelet-fibrin interactions are crucial for hemostasis and clot strength. Thromboelastometry can be used to assess these interactions. We explored fibrinogen's compensatory effect on clot strength in pregnant women with thrombocytopenia using thromboelastometry

Methods: Data was collected from pregnant women with and without thrombocytopenia that were admitted to various hospitals from 2015 to 2020. Seventy healthy and seventy thrombocytopenic third-trimester pregnancies were observed. Blood samples were routinely collected. Thromboelastometry was used to evaluate the impact of platelet count on clot strength using platelet-rich plasma. A retrospective analysis of thromboelastometry and other parameters was conducted in both groups.

Results: No differences were observed in age, white blood cell counts, neutrophil counts, red blood cell counts, hemoglobin, hematocrit, mean corpuscular volume, plateletcrit, mean platelet volume, prothrombin time, activated partial thromboplastin time, and thromboelastometry parameters [R-value, K-value, angle, and maximum amplitude between the two groups. The mean maximum amplitude of healthy women was close to the upper limit of the normal range, while that of thrombocytopenia was near the lower limit of the normal range. Changes in clot strength (expressed as maximum amplitude) positively correlated with increasing platelet counts in both groups (rA=0.529, rB=0.760 P< 0.01). Platelet count had more influence on maximum amplitude in the case of thrombocytopenia (Z=2.358>1.96, P< 0.05). Elevated fibrinogen levels may offset reduced clot strength in thrombocytopenia, offering an alternative to platelet transfusion. The study notes limitations, including its retrospective approach and small sample size.

Conclusion(s): Thromboelastometry may be useful in guiding fibrinogen repletion therapy and increasing fibrinogen concentrations is crucial.