Utilizing Thromboelastography to Assess the Efficacy and Safety of Aspirin in Preventing Pre-eclampsia

Backgroud Pre-eclampsia (PE), a hypertensive disorder uniquely associated with human pregnancy, poses a significant risk to both maternal and fetal health. The prophylactic administration of aspirin has been widely acknowledged as a strategy to mitigate the incidence of pre-eclampsia. However, despite its global recognition, a consensus on the optimal methodology for evaluating the efficacy of aspirin in preventing pre-eclampsia remains elusive.This study investigate the Utility of Thromboelastography (TEG) in Assessing the Efficacy and Safety of Aspirin for Preventing PE by Analyzing TEG Parameters. Methods Maternal cases from a tertiary hospital in Shenzhen between January 1, 2019, and March 31, 2023, were selected for TEG assessment after 26 weeks of pregnancy. Outpatient and inpatient medical records, along with data from the Shenzhen Maternal and Child Health Care Management Information System, were retrospectively reviewed. Pregnant women were categorized into control (62 cases), risk (62 cases), and aspirin (50 cases) groups based on the presence of pre-eclampsia (PE) risk factors, aspirin prophylaxis, and discharge criteria. TEG parameters, platelet counts, and coagulation indexes were compared among the groups, and differences in each parameter were analyzed. Maternal and neonatal outcomes were also compared, assessing the efficacy and safety of aspirin. Factors influencing the occurrence of pre-eclampsia were determined using binary logistic regression analysis. Results Significant differences were observed in the incidence of pre-eclampsia (8.06%, 30.65%, 10.00%, P=0.001), cesarean section (58.06%, 79.03%, 76.00%, P=0.023), and preterm delivery (16.13%, 40.32%, 26.00%, P=0.010) among the three groups. TEG parameters, including R value (X ² =12.977, P=0.011) and CI (X ² =12.357, P=0.015), exhibited significant differences across the groups. Coagulation index TT values also significantly differed among the three groups (H=13.567, P=0.001). Multivariate analysis identified prophylactic aspirin use as a protective factor against pre-eclampsia development (OR 0.357, 95%CI 0.120-1.066). Conclusion This study demonstrates that low-dose aspirin effectively prevents pre-eclampsia in high-risk pregnancies without additional risks, while TEG proves valuable for monitoring aspirin's anticoagulant effects and guiding individualized treatment.