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