Thromboelastogrpahy Reveals Kinetics of LPS- Induced Coagulopathy and Correlates to Fetal Outcome in a Rat Model of Pregnancy Complications.
Notice bibliographique
Résumé
Abstract Abstract 4200 Pre-eclampsia, intrauterine growth restriction (IUGR) and spontaneous abortion constitute the majority of serious complications of pregnancy. Women affected with these complications often exhibit excessive systemic inflammation, coagulopathies, and an increased risk of subsequent cardiovascular disease (CVD). Thromboelastography (TEG) has proven efficiency as a global test for monitoring hemostasis in hematological and non hematological conditions including pre-eclampsia. systemic administration of low doses of the immunogenic agent lipopolysaccharide (LPS) to pregnant rats has been shown to cause complications that recapitulate many of the features associated with human pregnancy disorders such as IUGR, hypertension, proteinuria, and pregnancy loss. In this study we investigated the acute hemsotatic events using TEG in pregnant rats at day 14 following injection of 100ug/ kg of LPS and correlated this to fetal outcome. Blood samples were withdrawn from 12 rats and tested for TEG at 1h (n=6) and 4h (n=3) post LPS and the results were compared to saline injected control rats (n=3). At 1h after LPS injection, 3 rats showed a DIC- like condition stage I (hypercoagulability with secondary fibrinolysis): in comparison to saline injected rats, there was significant shortening of R time (2.2 min. compared to 10.2 min. in saline control), increase in alpha angle, increase in overall clot index and significant increase in LY30 (p= 0.0001, 0.002, 0.03 and 0.05 respectively). The three other rats showed DIC stage II (hyperfibrinolysis): compared to saline control, there was significant shortening of R time, reduction in clot index, increase of LY 30 with no significant changes in alpha angle or MA (p=0.02, 0.03, 0.03, 0.3 and 0.6 respectively). After 4h of LPS injection, rats showed enhanced hyperfibrinolysis/ hypocoagulability indicating DIC stage III. In these rats, there were no significant changes in R time or alpha angle, significant reduction in MA, significant reduction in clot index and highly significant increase in LY30 (p=0.9, 0.8, 0.03, 0.03 and 0.001 respectively). The average lysis time was 13% in stage 1, 17 % in stage II and 39% in stage III compared to 1.7 % in saline control. Using ultrasound to determine fetal parameters, we observed fetal death occurring approximately 3-4 h after LPS administration as determined by loss of detection of heart rate and severe hypoxia. Doppler recordings also showed that fetal death was also associated with reduced blood flow through the spiral arterioles, which supply blood to the placenta. These data indicate that the acute LPS- induced hemostatic changes (both coagulation and fibrinolysis) in pregnant rats can be detected and monitored using thromboelastography and that these changes contribute to the negative fetal outcome. To our knowledge this is the first study that investigates LPS- induced acute hemostatic events in pregnant rats using TEG and correlates the changes over 4h hours period with the foetal outcome. The study provides potential for TEG utilization as a point of care device to predict both fetal and maternal outcomes in complicated pregnancies. Disclosures: No relevant conflicts of interest to declare.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».