• Malin Andersson, Peter Bengtsson, Ove Karlsson, Sven-Egron Thörn, Lilja Thorgeirsdottir, Lina Bergman, Jonatan Oras, and Birgitta Romlin.
• Department of Anesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: malin.ma.andersson@vgregion.se.
• Int J Obstet Anesth. 2024 Nov 21; 61: 104297104297.

BackgroundThrombocytopenia affects 12-20% of women with preeclampsia and a low platelet count impairs coagulation. Women with preeclampsia have an increased risk of both cerebral hemorrhage, thromboembolism, and postpartum hemorrhage. Studies of platelet function and coagulation in women with preeclampsia show conflicting results. Therefore, we aimed to study platelet aggregation and coagulation in women with preeclampsia.MethodWomen with preeclampsia and women with normotensive pregnancies were included prior to delivery in a prospective observational study as a part of the Gothenburg Preeclampsia Adverse Event (GoPROVE) Biobank and Database. Sampling and analyses were performed shortly before delivery. Platelet count was analyzed and impedance aggregometry was used for examining platelet adhesion and aggregation. Thromboelastometry was used to assess coagulation.ResultsNinety-three women with preeclampsia and 45 normotensive pregnant control patients were included. There was no difference in platelet aggregation (adenosine diphosphate, ADP-test), (arachidonic acid, ASPI-test) or (thrombin receptor-activating peptide, TRAP-test) between women with preeclampsia and women with normotensive pregnancies. Women with preeclampsia had lower platelet counts, shorter clotting (EXTEM-CT and INTEM-CT) and clot formation (EXTEM-CFT and INTEM-CFT) times than women with normotensive pregnancies. Platelet aggregation and coagulation were hyperactivated in women with preeclampsia and normal platelet counts. In women with preeclampsia and thrombocytopenia, platelet aggregation and thromboelastic tests of coagulation were impaired compared with normotensive pregnancies.ConclusionPlatelet aggregation and thromboelastic tests of coagulation are dependent on platelet counts in women with preeclampsia. At normal platelet counts, women with preeclampsia have hyperactivated tests of coagulation. In contrast, women with thrombocytopenia demonstrated lower coagulation test values.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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