Evidence map›Paper›PMID 33798794›Full record

ArticleInternational journal of obstetric anesthesia2021

Associations of thrombocytopenia, transaminase elevations, and transfusion with laboratory coagulation tests in women with preeclampsia: a cross-sectional study.

D J Combs, K J Gray, S Schulman, B T Bateman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of obstetric anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Association Betweenn Preoperative RDW and Postoperative Pulmonary Embolism in Trauma Patients: A Propensity Score-Matched Multicenter Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

D J CombsDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: djcombs@bwh.harvard.edu.
K J GrayDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
S SchulmanDivisions of Hemostasis and Thrombosis and Hematology and Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
B T BatemanDepartment of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Funding

Functional genetics of tissue factor in bleeding and thrombotic riskDP5OD028129 · OD · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHULMAN, SOL · 2019 to 2023
$2.2M
Signatures of dysfunctional mitochondrial fatty acid oxidation that predispose to early-onset preeclampsiaK08HL146963 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI GRAY, KATHRYN JOHNSON · 2019 to 2023
$940k
NHLBI NIH HHS K08 HL146963NIH HHS DP5 OD028129
6 · The paper itself

Abstract

backgroundWomen with preeclampsia may develop coagulopathy, predisposing to bleeding complications. Although guidelines and prior studies conflict, we hypothesized that in preeclampsia, abnormal coagulation test results are more common in women with thrombocytopenia or transaminase elevations and increase the transfusion risk. Our objectives were to investigate: 1. patterns of coagulation testing; 2. relationships between platelet count, transaminase level, and the risk of abnormal coagulation tests; 3. risk of bleeding complications; and 4. characteristics of patients with markedly abnormal coagulation parameters.

methodsWe conducted a cross-sectional study of deliveries of women with preeclampsia who had undergone activated partial thromboplastin time (aPTT) or international normalized ratio (INR) testing at one of two hospitals between 1994 and 2018.

resultsOf 10 699 women with preeclampsia, 3359 (32.7%) had coagulation testing performed and aPTT or INR elevations were present in 124 (3.7 %). Coagulation abnormalities were more common in women with thrombocytopenia or transaminase elevations (n=82) compared with those without (n=42) (6.7%, 95% CI 5.5 to 8.2 vs 1.8%, 95% CI 1.3 to 2.5). Transfusion was more common among women with abnormal coagulation parameters (n=124) compared with those without (n=39) (33.1 vs 7.0%, P <0.001). Among 26 patients with an aPTT ≥40 s or an INR ≥1.4, six required transfusion (all had placental abruption and disseminated intravascular coagulopathy).

conclusionsCoagulation testing was inconsistently performed in this cohort. Platelet counts and transaminase levels inadequately detected abnormal coagulation test results. Abnormal coagulation test results were associated with a markedly higher risk for red blood cell transfusion.

Indexed as

Pre-EclampsiaThrombocytopeniaBlood Coagulation TestsCross-Sectional StudiesFemaleHumansPartial Thromboplastin TimePlacentaPregnancyTransaminasesTransaminasesCoagulation testingCoagulopathyLiver functionPreeclampsiaThrombocytopenia

Identifiers

PMID33798794
PMCPMC8144064

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.