Objective  To explore the value of thromboelastography (TEG) in the evaluation of patients with severe preeclampsia (PE).

Methods  A total of 66 patients with severe PE from January 2021 to January 2022 in the Changzhou City Maternal and Child Health Care Hospital were selected as severe PE group, and 152 healthy pregnant women in the third trimester were selected as control group. Severe PE patients were divided into aspirin group (32 cases, treated with low-dose aspirin) and low molecular weight heparin (LMWH) group (34 cases, treated with LMWH). Before and after treatment, the coagulation-related function parametersplatelet (PLT), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), D-Dimer (D-D), TEG parametersresponse time (R value), coagulation time (K value), α angle, maximum clot intensity (MA value), comprehensive index for coagulation (CI value), neonatal outcome and maternal prognosis were compared between different groups.

Results  Compared with the control group, PLT decreased and D-D increased significantly in the severe PE group (P < 0.05). Compared with the control group, K value and R value in the severe PE group decreased significantly, while CI value and MA value increased significantly (P < 0.05). After treatment, CI value of TEG parameters decreased significantly in the aspirin group (P < 0.05); in the LMWH group, D-D and CI value decreased significantly, while K value and R value increased significantly (P < 0.05). Compared with the aspirin group, the cases with fetal growth restriction and postpartum hemorrhage were significantly less in the LMWH group (P < 0.05).

Conclusion  TEG combined with conventional coagulation test can better guide clinicians to treat patients in prethrombotic state, and can be used as an important method to evaluate the improvement of prethrombotic state of severe PE by anticoagulants such as aspirin and LMWH. LMWH is superior to low-dose aspirin in improving hypercoagulable state in patients with severe PE.