Work

Physiologic clot strength by thromboelastography at extremely low and normal platelet counts in thrombocytopenic pregnant patients

Year: 2026

Type: article

Abstract: Background: /L safe in low-risk patients, but uncertainty persists at lower levels. Thromboelastography (TEG) measures real-time clot dynamics and may offer physiologic insight beyond standard labs. Modern TEG runs multiple assays in parallel, including citrated kaolin (overall clot strength), citrated rapid TEG (accelerated clotting), and citrated functional fibrinogen (fibrinogen contribution). Its maximum amplitude (MA) reflects final clot strength and may help assess bleeding risk, but its relation to platelet count in pregnancy is not well defined. Objectives: To evaluate the relationship between thromboelastography (TEG) maximum amplitude (MA) and platelet count in pregnant patients with and without thrombocytopenia, and to determine the ability of MA (across CK, CRT, and CFF assays) to discriminate clinically relevant thrombocytopenia (<70×10⁹/L). Methods: /L. Bleeding symptoms were assessed using the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool questionnaire. Results: /L (area under the receiver operating characteristic curve = 0.855). Most patients reported low or no bleeding symptoms. No significant correlation was observed between MA and International Society on Thrombosis and Haemostasis Bleeding Assessment Tool scores. No neuraxial hematomas occurred. Conclusions: MA strongly correlates with platelet count in thrombocytopenic parturients even at low platelet counts, offering physiologic insight into clot strength and bleeding risk. These findings validate MA as a physiologic correlate of platelet-based clot strength. Thromboelastography may offer complementary physiologic insight into clot strength in parturients with low platelet counts, which can inform-but should not replace-clinical judgment.

Source: Research and Practice in Thrombosis and Haemostasis

DOI: 10.1016/j.rpth.2026.103378