Screening for consumptive coagulopathy in preeclampsia.

OBJECTIVE

To identify a practical and cost-effective profile of tests to screen for consumptive coagulopathy in preeclampsia (PE).

METHODS

Retrospective analysis of the results of measurements of platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen and D-dimers in 100 patients presenting with PE uncomplicated by other disease or antepartum hemorrhage. Twenty-four patients had pregnancy-induced hypertension only, and 76 hypertension with proteinuria.

RESULTS

The incidence of abnormal tests on presentation was raised D-dimers 34%, thrombocytopenia 14%, prolonged APTT 12%, prolonged PT 3%, and low fibrinogen 2%. Prolonged APTT without thrombocytopenia occurred in 8% of patients. In 19 patients with elevation of D-dimers alone, only one showed evidence of consumption of coagulation factors on subsequent testing.

CONCLUSIONS

A combination of platelet count and APTT is probably a practical and cost-effective combination to screen for consumptive coagulopathy in PE.