THROMBELASTOGRAPHY CHANGES IN PREECLAMPSIA AND ECLAMPSIA

We have measured platelet count, bleeding time and thrombelastography (TEG) variables and the correlation between these variables in 49 preg nant patients presenting with pre-eclampsia or eclampsia. Eighteen pat ients (37%) had a platelet count less than or equal to 150 x 10(9) lit re(-1) and seven (14%) had a platelet count less than or equal to 100 x 10(9) litre(-1). Bleeding time was prolonged > 9.5 min in 13 (27%) p atients and the TEG was abnormal in four (8%). The TEG variables, k ti me and maximum amplitude (MA) had a strong correlation with platelet c ount (k time-platelet count less than or equal to 150 x 10(9) litre(-1 ), r = -0.68, P = 0.003, platelet count less than or equal to 100 x 10 (9) litre(-1), r = -0.84, P = 0.02; MA-platelet count less than or equ al to 150 x 10(9) litre(-1) r = 0.72, P = 0.001, platelet count less t han or equal to 100 x 10(9) litre(-1), r = 0.78, P = 0.04). There was no correlation between bleeding time and thrombocytopenia (platelet co unt less than or equal to 150 x 10(9) litre(-1), r = -0.18, ns; platel et count less than or equal to 100 x 10(9) litre(-1), r = 0.09, ns). T here was no correlation between bleeding time and any measured TEG var iable. Of the 10 (20%) patients with an adequate platelet count (> 100 x 10(9) litre(-1)) but prolonged bleeding time, the TEG was normal, s uggesting adequate haemostasis. An MA of 53 mm, which is the lower lim it for normal pregnancy, correlated with a platelet count of 54 x 10(9 ) litre(-1) (95% confidence limits 40-75 x 10(9) litre(-1)). Although the number of patients with severe thrombocytopenia was small, a plate let count of 75 x 10(9) litre(-1) should be associated with adequate h aemostasis.