Coagulogram during pregnancy: what shows, decoding the result

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

In anticipation of a child, a woman undergoes several studies so that you can observe the course of the whole process, including their coagulogram. During pregnancy, it is carried out for every woman. But some expectant mothers are horrified by such a word. Although, in fact, there is nothing wrong with this, and this is just another procedure for passing an analysis during the period of bearing a child.

However, many women experience fear when a doctor prescribes this test for them. To dispel all fears, it is worthwhile to understand well what this study is and whether there really are any risks.

What kind of analysis is this?

Coagulogram is a rather complex study that allows you to assess the state of the hemostasis system. That is, using this analysis, you can identify any violations, if any.

The life support of a person fully depends on the state of the blood, and during pregnancythis is especially important. Mother Nature provided for everything and therefore created a hemostasis system that maintains the blood in the required state.

Understanding what kind of analysis it is - a coagulogram, will help to avoid unwanted stressful situations that only harm both the woman herself and the unborn child.

Due to hemostasis, the blood thickens when the vessels are damaged to avoid bleeding. It can also liquefy so that the circulatory system does not clog.

In other words, the coagulogram allows you to determine the degree of blood clotting. With high rates of hemostasis (hypercoagulation), blood clots form quickly, which threatens thrombosis, stroke or heart attack. In the case of a decrease in hemostasis (hypocoagulation), blood clots form much more slowly, which is also not beneficial. In this case, even minor damage to blood vessels can lead to large blood loss.

Role of analysis

During the gestation period, an important role is given to the indicators of the coagulogram. During pregnancy, the state of hemostasis is very important. So, if hypocoagulation is detected, the risk of miscarriage increases, moreover, spontaneous and premature delivery, and at the birth of a child, there may be heavy blood loss.

Of all the complications of pregnancy, the most serious are preeclampsia, venous thrombosis, thrombophilia. A coagulogram allows you to identify any possible deviations and prevent the development of some complications. As for such a case as vein thrombosis, thenpregnant women are 5 times more likely to have it!

Need for testing

What is the analysis, now it is clear, but is it necessary to take it for pregnant women? Soon everything will be clear. During the period of bearing a child, it is important that hemostasis indicators adhere to the norm. Such a phenomenon as hypercoagulation is fraught with a variety of undesirable consequences. To more accurately understand the coagulogram, what kind of analysis it is, you need to find out why it is necessary to take it.

Through the placenta, the baby receives oxygen and other essential nutrients and trace elements. And here it is important what condition the mother's circulatory system is in. In the presence of a thrombus, the blood supply is disrupted. As a result, the fetus is formed defectively. This happens due to a deficiency of substances, including oxygen starvation (hypoxia). Ultimately, if the pregnancy continues in this form, the child will inevitably be born with some kind of anomaly.

In addition, blood supply failures increase risks:

• Abortion.
• Preeclampsia in severe form.
• Fetoplacental insufficiency.
• Clot formation in vessels of particular importance.

In the case of hypocoagulation, there is a threat of blood loss, which is incompatible with life. And in late pregnancy, the placenta can exfoliate.

Indications for research

The main indications for a coagulogram during pregnancy are the presence of pathologies associated with the circulatory system (varicose veins,liver disease, autoimmune disorders, etc.). Women with hereditary disorders in terms of bleeding disorders should undergo this test without fail.

In addition, it is worth highlighting other indications for analysis:

• hard work;
• missed pregnancy, abortion, miscarriage;
• cardiac abnormalities.

It is easier to prevent a pathology than to treat it later. In this connection, determining the degree of blood coagulation in the mother will avoid any abnormalities in the fetus, and the baby will be born full and he althy.

How to prepare for a coagulogram during pregnancy?

There is no special preparation, however, a few simple recommendations should be followed. This will allow more accurate research. The test is taken in the morning and always on an empty stomach, that is, the last meal - at least 8 hours before.

Also, before the procedure, you should refrain from drinking alcohol, smoked meats and spicy foods, refuse fatty foods and cigarettes. This can also include those drugs that affect blood clotting.

From liquids, only ordinary drinking water is allowed, and juices, compotes, teas, coffee and other similar drinks are prohibited before taking the test. 30 minutes before the examination, you need to calm down and try to avoid panic and fear. This is very important, because due to stressful influences, real readings canchange, which may give a false result.

Experts recommend drinking a glass of water and relaxing 10-15 minutes before sampling.

Analysis

And how to take a coagulogram during pregnancy? To determine the state of hemostasis, a material from a pregnant woman is taken from a vein in the elbow bend. If there are no deviations from the norm in the readings of the analysis, then the analysis is given according to the plan.

And this is three times:

• When a woman is registered for pregnancy.
• Second trimester - 22 to 24 weeks.
• Third trimester - 30 to 36 weeks.

However, if any deviations are detected, the procedure is carried out more often. They may be the following pathologies of the mother:

• Violation of the liver and gallbladder.
• Autoimmune pathologies.
• Varicose.
• Complex pregnancy (IVF).
• Violation of the heart or vascular system.
• Infertility.

An additional test may be ordered if the woman is taking a number of medications (like anticoagulants). It also includes cases of operations and serious medical intervention.

However, it is necessary to take an analysis for a coagulogram during pregnancy not only during the period of bearing a child, but also at the stage of its planning. Then, if deviations are found, the doctor will be able to select the necessary treatment, which will contribute to a better conception and bearing of the child without any deviations andcomplications.

Transcript of results

Deciphering the results is done only by a specialist, it is very difficult to figure it out on your own, and it is not recommended to avoid unnecessary stress. Only a doctor will be able to assess the state of hemostasis and determine the degree of blood clotting.

The main indicators of the coagulogram are:

1. D-dimer.
2. Antithrombin III.
3. APTT.
4. Lupus coagulant.
5. Prothrombin.
6. Platelets.
7. Thrombin time.
8. Fibrinogen.

All of these indicators can indicate how the pregnancy is proceeding, whether there are any pathologies that pose a serious threat to the life of the mother or child. Moreover, even minor deviations can be detected. Let us examine in a little more detail what the coagulogram shows during pregnancy.

D-dimer

Is a protein formed after the breakdown of fibrin, and is an important indicator for the detection of thrombosis. With the onset of a new month, its content increases, and immediately before childbirth, the maximum concentration of these elements is collected.

Under normal conditions during pregnancy, the increase in this protein occurs smoothly. Sharp jumps indicate the presence of kidney disease, preeclampsia or diabetes. The following values can be considered the norm:

• first trimester - 750 ng/l;
• second trimester - 1000 ng/l;
• third trimester - 1500 ng/l;

Exceeding the norm may indicate placental abruption, which, in turn, endsmiscarriage. It can also mean the risk of increased thrombosis. Low values mean heavy blood loss.

Antithrombin III

This protein is responsible for slowing down the process of blood clotting. If the transcript of the coagulogram during pregnancy shows a low content, then the risk of thrombosis increases. And at high concentrations, uncontrolled bleeding can occur. In pregnant women, the norm is 75–125%.

Lupus coagulant

These are antibodies that oppose the formation of thrombin from prothrombin. During pregnancy, this indicator should not be. Otherwise, you can judge the presence of autoimmune unwanted changes. In this case, the woman's body begins to perceive its own cells as foreign and, accordingly, destroys them.

This phenomenon may be characteristic of antiphospholipid syndrome or lupus erythematosus. As a rule, pregnancy in this case ends tragically:

• placental abruption;
• spontaneous interruption;
• fetal death.

In addition, lupus anticoagulant can be detected in the blood of a pregnant woman with a negative Rh or Rh conflict, including severe preeclampsia.

APTV

Fully stands for: activated partial thromboplastin time. Here, too, it is especially important to adhere to the norm of the coagulogram during pregnancy, since this is also an important indicator of hemostasis,denoting the amount of time it takes for blood to clot. Moreover, in pregnant women, this process proceeds more rapidly than in ordinary women. This is due to the influence of fibrinogen.

Usually, this figure is normally 24-35 seconds, but in pregnant women it is even lower: 17-20 seconds. This is due to the fact that the female body is preparing for the birth of a baby and at the same time for the inevitable blood loss.

The increase in time is a warning sign - in this case, the blood clots more slowly, and there is a threat of profuse bleeding. Too low indicators are also not good, as the risk of blood clots increases.

Thrombin time

This term refers to the time it takes for fibrinogen to fibrin to be converted. During pregnancy, there is a constant increase in fibrinogen in the woman's blood. As a result, the time of the conversion process itself also increases.

Normally, a coagulogram during pregnancy should show from 18 to 25 seconds. Exceeding these values indicates abnormal liver function, as well as a lack of vitamin K.

Prothrombin

Another protein compound that is present in human blood. And it is from such a “material” that thrombin is “built”, which is the main source of thrombus formation. This indicator helps to determine the degree and speed of blood clotting, as well as its consistency.

Normally, the content of prothrombin should be in the range of 80-140%. A significant excess already gives cause for concern, sincehow placental abruption can happen, which, in turn, can provoke a spontaneous miscarriage.

Fibrinogen

This is a kind of fibrin precursor, and this protein can be considered special, because it is thanks to it that the blood clot is formed. Like D-dimer, fibrinogen increases with each new month of the pregnancy period, and reaches its maximum concentration before the birth of a child.

The norm is the amount of protein equal to 6.2-6.5 g/l, no more. Otherwise, this is already a bad coagulogram during pregnancy, an inflammatory process occurs in the woman's body.

Platelets

These cells are essential elements of human blood. They originate in the bone marrow, and they are directly related to the process of plasma coagulation. During the bearing of a child, their concentration decreases slightly, which in no way affects the process itself. Moreover, the key feature is just a slight deviation.

The content of platelets in the amount of 130-400 thousand per µl is considered normal. If the concentration drops significantly, then this may indicate a serious pathology in the body of a pregnant woman. This can happen for various reasons, one of them is malnutrition, progressive DIC, etc.

Advanced and simple analysis

Of all the indicators considered, antithrombin III, D-dimer and lupus anticoagulant are related to the detailed coagulogram during pregnancy. Everything else is a simple procedure.

Detailed analysisnecessary if any problems are found in the readings. It is carried out instead of a simple study or immediately after it. There are also some indications for an extended study:

• Woman failed to conceive a child for a long time.
• A successful attempt to get pregnant has always led to one result - its termination.
• Preeclampsia in severe form.
• Hereditary blood diseases.
• Expecting twins, triplets, etc.
• Fetal death.

Many expectant mothers begin to try to decipher what the coagulogram shows on their own.

And after that they start making decisions, and most of them are just terrible. Enlisting the support of “knowledgeable” specialists, future mothers intentionally and unknowingly endanger not only themselves, but also the child.

Result

A pregnant woman who is preparing to become a mother needs to monitor her he alth if she wants to hug a full-fledged baby without any deviations and pathologies. And for this, it is necessary to undergo research in a timely manner and take all the tests, not forgetting about the coagulogram during pregnancy. Only in this case, you can fully experience the joy of motherhood!