Hemostatic Parameters in Women with Obstetric Hemorrhage

Aims: To find out the relationships observed in hemostatic parameters during the course of obstetric hemorrhage for an effective hemostatic management and goal directed therapy.

Study Design: Analytical, Case-Control Study.

Place and Duration of Study: Department of Obstetric and Gynaecology,Department of Pathology, Govt Medical College, Kottayam, Duration:12 months.

Methodology: We included 68 cases (18-45 yrs) with obstetric hemorrhage and 68 controls (18-45 yrs, Third trimester) without Obstetric hemorrhage.Blood collected for PT,APTT,Fibrinogen and platelet count in sodium citrate and EDTA anticoagulated samples. PT, APTT, Fibrinogen assay done by Automatic methods, platelet count done in 5 part coulter machine.

Results: The study, involving 136 participants divided into case and control groups, revealed significant differences in key haemostatic parameters. The case group exhibited elevated Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) values, along with lower Platelet count and Fibrinogen concentration compared to the control group. Notably, Antepartum Hemorrhage (APH) and Postpartum Hemorrhage (PPH) showed a substantial linear relationship with platelet levels in the case group, emphasizing the potential predictive role of platelet counts in hemorrhagic events associated with obstetric conditions.

Conclusion: study sheds light on the critical link between obstetric hemorrhage and hemostatic parameters, highlighting significant variations in prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count, and fibrinogen concentration between women with and without obstetric hemorrhage. The findings underscore the complexity of managing obstetric hemorrhages and the importance of laboratory-based screening in evaluating the coagulation status of affected patients.