The physiological changes in pregnancy result in a hypercoagulable state. The concentration of most coagulation factors increases, while factor XI and factor XIII decreases leading to activation of the clotting system. During the first 3 to 5 days postpartum, changes in various procoagulant factors may account for greater incidence of thrombotic complications during the puerperium. 

It has been reported that the risk of thrombosis after vaginal delivery was 1 per 1000 while this risk reaches 3 per 1000 after Caesarean section. The mortality associated with venous thromboembolism after Caesarean section is increased 10-fold compared with women who undergo vaginal delivery.

The conventional blood coagulation tests (prothrombin time, activated partial thromboplastin time, international normalised ratio, platelet count, bleeding time) do not provide a complete picture of hemostasis due to their inability to assess some coagulation factors (such as Factor 13), platelet function and the activity of the fibrinolytic system.

On the other hand, thromboelastography (TEG) is a single test that quantitatively measures the ability of whole blood to form a clot and has become a reliable point-of-care assay for detecting various coagulopathies. In this regard, the advantage of thromboelastography over conventional coagulation parameters include real time assessment to know whether the patient is hypocoagulable, hypercoagulable or fibrinolytic. The aim of the present is to evaluate the role of TEG, in identifying haemostatic alterations in healthy pregnant women undergoing Caesarean delivery and vaginal delivery.