Why should the hemostasiogram be included in the list of mandatory tests for pregnant women?
To perform their functions in our body, the blood must be in a certain liquid state, which on one side supports hemostasis (coagulating blood system), and on the other, an anticoagulant system. The well-coordinated work of these two systems ensures normal blood condition. But a malfunction in this work towards the activation of one of them can lead either to an increase in the density of blood and the formation of clots, or to too liquid its condition and bleeding.
During pregnancy, women undergo physiological changes in the system of hemostasis due to the appearance of an additional uterine-placental circle of blood circulation, changes in the hormonal background and preparation for natural blood loss in childbirth. A significant increase in blood clotting can lead to the development of DIC syndrome (disseminated intravascular coagulation), which in turn can cause a violation of the placental blood flow, as well as the fading of pregnancy and fetal death.
Another extreme of the disbalance in the coagulation and anticoagulant system is too much blood thinning, which can lead to severe bleeding in labor.
In order to avoid the problems listed above, a study of blood clotting parameters or a hemostasiogram is performed. As a rule, the haemostasiogram is done several times during the entire gestation period for the timely treatment of possible hemostasis disorders. In addition, this analysis is necessarily prescribed in the following cases:
- the woman had several frozen pregnancies or miscarriages;
- There are signs of gestosis: swelling of the hands and feet, high blood pressure, the presence of protein in the urine (gestosis is better to prevent - to pass the hemostasiogram before or early in pregnancy);
- there is a threat of abortion (hypertension of the uterus).
What can the hemostasiogram tell about?
We list the main parameters of the study, which enable the doctor to determine the state of coagulation and anticoagulation systems:
APTT - activated partial thromboplasty time or, in other words, an indicator of blood coagulation time. The standard of this indicator is 24-35 seconds. Reduction of time speaks about the accelerated coagulation of blood, which in turn is an indicator of DIC-syndrome. And, conversely, if APTT is more than 35 seconds - the blood is poorly coagulated and there is a threat of postpartum bleeding.
Prothrombin or prothrombin index is an indicator that also reflects the quality of blood clotting. The values ??from 78% to 142% are considered the norm. A decrease or increase in the percentage indicates a delayed or accelerated blood clotting.
Antithrombin III is a protein, the blood that inhibits the coagulation processes. Its norm is considered to be between 71% and 115%. A decrease in the level of antithrombin III entails the possibility of blood clots, and an increase leads to a risk of postpartum hemorrhage.
Thrombin time (TB) is the time of the last stage of blood clotting. Normally this process takes from 11 to 18 seconds. A shorter time (up to 11 seconds) indicates symptoms of DIC syndrome, more - warns about the possibility of postpartum hemorrhage.
The D-dimmer is the most important indicator of the hemostasiogram, which allows you to know about the increase in blood clotting. Normally, the value of the D-dimmer should be less than 248ng / ml. A greater value indicates too dense, viscous, blood-prone blood clots.
RCMF is a marker of intravascular coagulation, exceeding the norm of which (more than 5, 1 mg per 100 ml) indicates an ICE-syndrome.
The above parameters are basic and can be supplemented by other indicators. It should also be noted that the outcome of the hemostasiogram can be affected not only by pregnancy, but also by other factors, for example: internal diseases, lack of vitamins and trace elements, taking certain medications, injuries and bruises. All this is taken into account by the doctor when deciphering the results of the analysis.
Treatment of blood system disorders
There may be several causes of abnormalities in coagulation and anticoagulation systems, so it is better to investigate possible abnormalities before pregnancy. This is especially true for women who have:
- someone from close relatives had a stroke, heart attack, thrombosis;
- Mom or grandmother has varicose veins;
- were frozen or interrupted by a natural way of pregnancy;
- There are diseases associated with the violation of the circulatory system.
On the basis of the obtained data of the hemostasiogram doctor can determine the deviations in the work of blood systems and prescribe the necessary treatment both before and during pregnancy.
Pregnant women are often afraid of any medication, but preparations for normalizing the blood systems prescribed during pregnancy do not have a negative effect on the baby. Women who do not refuse treatment, significantly increase their chance of bearing a healthy baby and avoid severe bleeding in childbirth.