Predictive value and application of thrombelastography combined with coagulation parameters for adverse pregnancy outcomes

Abstract

Objective: To evaluate the predictive value and clinical utility of thrombelastography (TEG) combined with coagulation parameters for adverse pregnancy outcomes (APOs).

Methodology: A retrospective analysis was conducted on the clinical data of 186 pregnant women admitted to the Department of Obstetrics in Affiliated Hospital of Chengde Medical College between January 2022 and June 2025. Based on pregnancy outcomes, patients were classified into the APO group and the normal pregnancy outcome group. Baseline characteristics, TEG parameters, and coagulation parameters were compared between groups. Pearson correlation analysis was performed to assess associations between TEG and coagulation parameters in the APO group.

Results: No significant differences were observed between the two groups in baseline characteristics such as age, gravidity, parity, and gestational weight gain (all P > 0.05), indicating comparability. Regarding TEG parameters, the APO group showed lower R values and higher maximum amplitude (MA) and coagulation index (CI) values compared with the normal outcome group (P < 0.05, respectively). For coagulation parameters, fibrinogen (FIB) and D-dimer (D-D) levels were significantly elevated, while antithrombin III (AT-III) levels were decreased in the APO group (P < 0.05, respectively).

Conclusion: The combination of TEG and coagulation parameters demonstrates higher predictive efficiency for APOs than either method alone, providing a reliable basis for the early identification of high-risk populations and guiding clinical intervention strategies.