Thromboelastographic Evaluation of the Coagulation Profiles of Full-Term Neonates after Cesarean Section Delivery

Jin, Soon Young; Lee, Sang Kyi; Son, Ji Seon; Choe, Huhn

Abstract

BACKGROUND: Neonatal coagulation systems are quantitatively deficient and immature. Clinical experience, however, does not indicate an increased risk of excessive bleeding associated with surgical procedures in the neonatal period. Moreover, the coagulatory function of neonates by thromboelastography (TEG) is not well known. In this study, we used TEG to assess the coagulation system of term neonates and their pregnant mother to obtain TEG variables of term neonates, and to identify differences between the coagulation systems of term neonates and pregnant mother.
METHODS
TEG was performed on 30 pregnant women that underwent Cesarean section delivery using native whole blood, and on their 30 neonates delivered by Cesarean section using umbilical cord venous blood. Blood samples were collected immediately after delivery and TEGs were measured. The TEG variables included reaction time (R), clot formation time (K), maximum amplitude (MA), alpha angle, TEG coagulation index and percentage reduction in MA at 30 minutes (LY30) and 60 minutes (LY60).
RESULTS
TEG measurements in neonates were R (mm): 9.7 +/- 5.3 (5.0-18.5), K (mm): 7.5 +/- 2.9 (4.0-12.5), MA (mm): 42.4 +/- 7.8 (25-53.0), alpha angle (o): 46.5 +/- 15.1 (31.0-64.5), TEG index: -0.3 +/- 1.3 (-2.58-+ 1.78), LY30 (%): 30.0 +/- 21.4 (1.5-62.5), LY60 (%): 43.4 +/- 24.7 (5.0-64.5). The R, MA and TEG coagulation indexes were significantly lower in neonates than in their pregnant mother (P <0.05). However, LY60 was significantly higher in the neonates than in the pregnant mother (P <0.05).
CONCLUSIONS
We obtained TEG measurements in neonates immediately after Cesarean section delivery, and found differences in the TEG-defined coagulation systems of term neonates and their pregnant mother.