Increased blood clotting during pregnancy, what to do. Norm of blood clotting in pregnant women, blood during pregnancy

One of necessary research Pregnant women are diagnosed with blood clotting during pregnancy; this test is also called a coagulogram. The analysis shows the presence of disturbances in the hemostasis system, which is responsible for the fluidity of blood and its coagulation when a vessel is damaged. Blood clotting can be impaired in two cases - with hypercoagulation and hypocoagulation. Both conditions for pregnancy are dangerous due to miscarriage, premature delivery and large blood losses during childbirth. A blood clotting test in pregnant women is necessary to monitor the patient’s condition and possible risks for the fetus. Normally, it is taken three times during the entire gestation period. Why do you need to take a coagulogram, what do its indicators mean, when should you worry and take action?

Blood clotting indicators during pregnancy should remain within normal limits. If hypercoagulability occurs, when coagulability is increased, clots quickly form, which may result in pregnancy complications. Oxygen and nutrition are delivered to the fetus through placental tissues, which are literally penetrated by many vascular channels. If they begin to become clogged with blood clots against the background of increased blood clotting, then due to poor circulation the child will suffer from hypoxia, lack of nutrition, vitamins and other necessary substances. This increases the risk of developing congenital pathologies, interruption or placental insufficiency, as well as the development of severe preeclampsia.

No less dangerous is hypocoagulation, which is reduced hemostasis and insufficient thrombus formation. This condition develops against the background of a natural decrease in immune defense, which is necessary to prevent fetal rejection. Hypocoagulation can lead to placental abruption. The danger of such a state lies in high risk heavy blood loss, fraught with the death of the mother during childbirth. This is why testing for blood clotting during pregnancy is so important.

Indications for the procedure

Normally, during pregnancy, a coagulogram is performed three times: when registering for obstetric registration, in the 2nd trimester (22-24 weeks) and in the third trimester (30-36 weeks). Such a research schedule is observed only when gestation is proceeding normally. But there are additional indications for which the study is performed somewhat more often.

If there are serious concerns about the safety of the pregnancy, the test may be prescribed monthly.

Preparing for a coagulogram

Any analysis requires some preparation so that the results are as informative as possible. It is also recommended to comply with certain requirements before the coagulogram. Firstly, you will have to refuse food approximately 10-11 hours before the diagnosis, and you cannot even drink tea or juice, only drinking water is allowed. Biomaterial is taken from a vein in the morning.

Secondly, research has proven that psycho-emotional experiences can distort the true diagnostic results. Therefore, it is recommended that mommy sit down and calm down, only then can she go into the room for a blood draw. Don’t forget about medications; if you are taking anything, you need to warn a specialist about it.

Normal coagulation rate during pregnancy

So, having analyzed individual coagulogram indicators, we can identify their specific norms for pregnant women.

Decoding the results

Blood clotting during pregnancy has many indicators and clotting factors, but there are also basic ones that can be used to assess the course of pregnancy and the likely risks. Typically, an abbreviated coagulogram indicates the values ​​of aPTT, fibrinogen and prothrombin; with a detailed study, additional values ​​are indicated.

APTT

The APTT component represents the period during which partial blood clotting occurs. In non-pregnant patients given value is about 24-35 seconds. Any injury to the body can affect this value. In pregnant women, the aPTT may be lower, up to 18-20 seconds. Similar phenomenon explained by the preparation of the mother's body for the upcoming blood loss during childbirth. If the aPTT is significantly lower than 18, then this may warn of the threat of disseminated intravascular coagulation. At increased rates hypocoagulation is diagnosed, which develops for many reasons.

Fibrinogen

This substance of protein origin, from which fibrin is subsequently formed, is produced by the liver. This is the main thrombus-forming element. Due to the formation of the uteroplacental vascular network, indicators increase closer to childbirth. If fibrinogen abnormalities are observed, this indicates probable inflammation in the maternal body and even necrotic processes. During pregnancy, fibrinogen levels change noticeably:

• If there is no pregnancy – 2.3-5 g/l;
• In the first trimester – 2.4-5.1 g/l;
• In the second – 2.9-5.4 g/l;
• During the third trimester – 3.7-6.2 g/l.

When fibrinogen is normal, then at the slightest vascular damage, the protein accumulates in this area, forming an insoluble clot that clogs the wound and stops bleeding. Any deviations from the norm require more close attention specialists. Increased levels of fibrinogen are observed during influenza infections and inflammations, extensive burns and elevated level estrogen, with recent surgical interventions, disorders of protein metabolism, etc. Fibrinogen deficiency is observed with gestosis and disseminated intravascular coagulation, deficiency of ascorbic acid and B12, myocardial failure, etc.

Prothrombin

One of the most important indicators blood clotting in pregnant women. It shows the performance and functionality of hemostasis. Normally, the prothrombin content should be about 80-140%. Using this indicator, specialists will promptly identify signs of thrombotic processes, which will save the baby and the mother herself. The reason for the decrease in these indicators may be factors such as insufficient absorption of vitamin K, functional disorders liver and insufficient production of vitamins.

If deviations of this indicator are detected below the norm, an extended coagulogram, a study of enzymatic liver substances, etc. are performed. If prothrombin is exceeded, the causes may be factors such as a tendency to thrombosis or taking medications that interfere with the absorption of vitamin K.

Platelets

These are cellular structures of the blood that are actively involved in blood clotting processes and are responsible for the state of the hemostatic system. In pregnant women, their indicators decrease slightly, but if the decrease is quite significant, this indicates the presence of pathological factors.

Platelets are formed in bone marrow structures and are actually the main part of the blood clot that forms when the vessel wall is damaged. In case of acute platelet deficiency, the blood is said to be too thin, which is dangerous. heavy bleeding and internal hemorrhages.

Thrombin time

Thrombin time is the period during which a blood clot forms. In pregnant patients, the thrombin time is about 9.5-25 seconds. If the indicators are higher, this may indicate the presence increased bilirubin, low fibrinogen and liver pathologies. When thrombin time is less than 9.5 seconds, the development of disseminated intravascular coagulation and increased fibrinogen levels are suspected.

Thrombin time shows plasma blood clotting ability. This indicator is very important during pregnancy, since its abnormal level indicates the development of such pathological conditions, such as hemophilia, liver pathologies and other coagulation disorders. Normally, in the absence of pregnancy, a woman’s thrombin time is about 12.7-15.4 seconds, but upon conception its indicators change:

• In the first trimester, thrombin time is 9.7-13.5 seconds;
• In the second trimester – 9.5-13.4 seconds;
• In the third – 9.6-12.9 seconds.

In some laboratories, thrombin time values ​​in pregnant women are considered normal: 11-18 seconds. An increase in the indicator may indicate a threat of bleeding and heavy blood loss, the formation of hematomas, etc.

Antithrombin III

This substance belongs to complex proteins, its task is to inhibit blood clotting. Antithrombin is necessary to prevent the accumulation large number blood clots in the vascular passages. Normally, the level of antithrombin in pregnant women reaches 70-120%. An increase in antithrombin may be a sign of acute hepatitis or any inflammatory process, bile stasis and vitamin K deficiency, taking anticoagulants or acute pancreatitis.

Decreased antithrombin levels may indicate chronic failure kidneys, vascular blockage or atherosclerosis, and is also observed during treatment with Heparin and acute disseminated intravascular coagulation syndrome.

Lupus anticoagulant

These antibodies, when formed in the body, stop the conversion of prothrombin to thrombin. In healthy patients, this component is absent in the blood. This indicator refers to the most dangerous manifestations. If it is detected, then the pregnant woman develops a systemic autoimmune pathology like lupus erythematosus, during which her own cellular structures are perceived as foreign, and therefore antibodies begin to be produced against them. In pregnant women, lupus anticoagulant can also be detected with the development of preeclampsia, in which extensive vascular thrombosis develops. If pregnancy occurs with such a pathological disorder, then most often it ends in a heart attack, spontaneous interruption, intrauterine fetal death or placental abruption.

As gestation progresses, the indicators change, coagulability increases, which is associated with preparation for childbirth. The results of a coagulogram should only be assessed by a specialist, since the patient will not be able to correctly decipher them on her own, unless, of course, she is a qualified doctor.

If a pregnant woman’s bleeding stops faster than after 3-4 minutes, the doctor may diagnose “increased blood clotting.”

What are the reasons for the development of pathology, how dangerous it is and whether it is possible to return normal blood parameters - these and other questions are discussed in the article that is now in front of you.

Blood is a liquid medium that is in constant motion. The liquid must have a certain thickness and viscosity.

Only if these parameters are observed can it circulate freely through the vessels and capillaries.

If a failure occurs in the system that maintains the thickness and viscosity of the blood, a pathology such as increased coagulability (thrombophilia) occurs.

Reasons for increased coagulability:

Increased blood clotting is not always a pathology. In some conditions, increased clotting is the body's defense mechanism against bleeding.

Pregnancy is one of these conditions. But usually increased coagulability is undesirable, as it contributes to the formation of blood clots, the development of heart attack and stroke.

People with hypercoagulability become fatigued more quickly because their heart muscles work harder to push thick fluid through narrow capillaries.

Another symptom of increased coagulability is swelling of the lower extremities at the end of the day.

To determine thrombophilia, a blood test is performed, during which the following is determined:

• prothrombin is a complex protein that affects the rate of thrombus formation;
• thrombin is an enzyme formed from prothrombin that accelerates the conversion of fibrinogen to fibrin;
• fibrin is a high-molecular protein in the form of long fibers, the clots of which serve as the basis of a blood clot.

During the study, the prothrombin index is determined, which can be low or high.

Any reasons affecting the synthesis and breakdown of fibrin increase or decrease blood clotting.

Increased blood clotting occurs due to excessive amounts of fibrin. Normal level fibrinogen in the blood is 1.5 – 3.0 g/l.

Exceeding or decreasing this indicator is the reason for abnormally low or high blood clotting.

Indicators during pregnancy

Increased blood clotting during pregnancy is observed in all women. The expectant mother undergoes all kinds of examinations.

One of mandatory tests– blood test for coagulation. It's not hard to see why this test is so important. A woman is about to give birth - a process accompanied by ruptures and other injuries.

The blood should clot quickly - this will help avoid large blood losses that are life-threatening for the mother in labor. It is not surprising that obstetricians and gynecologists carefully monitor blood clotting.

During pregnancy, significant changes occur in hormonal background. Under the influence of hormones, a number of changes occur in the body of the expectant mother, including changes in blood parameters.

Coagulability increases from the very beginning fourth month pregnancy, and factors interfering with this process are reduced.

TO last trimester the blood thins out a little, as the number and lifespan of platelets is reduced, but the coagulation rate still remains above normal.

The described process is natural - it can always be observed if the pregnant woman is healthy.

Increased blood clotting in mid-pregnancy is a protective function of the body.

At this time, the blood supply to the placenta increases, as unborn child needs increased nutrition.

Childbirth or a miscarriage at this stage would kill a woman in a few minutes - the blood loss would be too severe.

Increased blood clotting in the second half of pregnancy helps preserve the life of the woman in labor.

Natural changes in blood clotting in pregnant women can be interfered with by:

• late and early pregnancy;
• diseases of the endocrine glands;
• kidney pathologies, of cardio-vascular system;
• frequent stress.

If a blood test reveals a deviation from the norm of coagulation, then you need to immediately begin correcting the parameter.

The expectant mother is prescribed a course of vitamins and antioxidants to help restore normal blood characteristics.

A gynecologist can prescribe heparin to a pregnant woman. Medicines of this class do not penetrate through placental barrier and do not pose a threat to the fetus.

However, only a doctor can prescribe them, and according to very strict indications - when the risk is from possible reception drugs are less than the risk of bleeding.

In the first trimester of pregnancy, ideally, medications are not taken at all. A relatively safe period is the second trimester, and it is precisely at this time that increased blood clotting is observed.

If the coagulation rate in the second trimester is not within the reference range, then the doctor has the right to prescribe medications from the category of anticoagulants.

Treatment of excess clotting

Thrombophilia is diagnosed using a blood test called a coagulogram. Only a doctor can correctly assess coagulogram parameters and find the causes of increased coagulation.

During the study, the following is determined:

• bleeding time is normal for pregnant women from 2 to 3 minutes;
• prothrombin index - if the parameter is above 142%, then we can say that coagulation is increased;
• fibrinogen – in pregnant women with toxicosis, there is often not increased, but rather decreased fibrinogen;
• APTT – if the reading is above 36 seconds, the doctor can diagnose “reduced coagulation.”

Extremely high thrombophilia requires treatment. Anticoagulants are rarely prescribed to a pregnant woman.

Most likely, the gynecologist will advise you to drink more water and reduce the proportion of foods containing iron in your diet: liver, beets, buckwheat, red fruits and berries.

Per day to the expectant mother you need to consume at least one and a half liters clean water. Walks in hot weather are fraught with thirst and can increase clotting, so a pregnant woman should not leave the house in the sun.

To thin the blood, in addition to water, drink herbal drinks and green tea. The diet should be enriched with bell pepper and sprouted wheat - these products are rich in vitamin C and nicotinic acid, useful for blood vessels.

A pregnant woman will greatly benefit from plant foods rich in natural moisture: cucumbers, red grapes.

Almonds, seafood and walnuts. It's best to avoid citrus fruits.

Despite the fact that oranges and tangerines are juicy fruits, they contain diuretics - substances that accelerate the removal of fluid from the body and contribute to the thickening of plasma.

By taking timely measures to thin the blood, the expectant mother will avoid such problems as varicose veins. Pregnancy and childbirth - common reasons this venous disease.

Treatment of thrombophilia should be accompanied by constant laboratory monitoring. Expectant mothers with increased clotting undergo a platelet test every 10 days. For pregnant women without coagulation abnormalities, it is enough to do a coagulogram once every trimester.

So, thrombophilia during pregnancy is quite normal phenomenon, if the coagulogram parameters are within normal ranges.

If the coagulogram indicators exceed the norm, measures must be taken to reduce thrombophilia.

The arsenal of techniques for liquefying plasma in pregnant women is small, since expectant mothers cannot take anticoagulants.

A pregnant woman should restore normal parameters of thickness and viscosity, observing drinking regime and diet.

During pregnancy, blood clotting is determined by performing a hemostasiogram (coagulogram). This is necessary to identify indicators that affect pregnancy and childbirth. If deviations are detected, therapy should be carried out to protect the woman and her baby.

A hemostasiogram is taken in each trimester of term. It can be performed unscheduled (according to indications). Eating before the test is prohibited. Since the mechanism of childbirth is accompanied by significant blood loss, a coagulogram is of paramount importance to prevent dangerous consequences.

How does the blood clotting process take place?

Injury to the vascular walls provokes the production of a special substance – thromboplastin, which stimulates the blood clotting process. Next, special proteins are activated. Their activity leads to the appearance of a blood clot in the injured area.

At the final stage, thrombin is transformed into fibrin. This substance accumulates platelets and other blood components. Platelets compress the clot, resulting in the formation of a blood clot to close the wound in the vessel wall.

Normally, blood is in a liquid state and circulates freely through the vessels, saturating all organs nutrients. Malfunctions of the anticoagulant system lead to the pathological occurrence of blood clots.

Interpretation of hemostasiogram indicators during pregnancy

By performing a coagulogram, various indicators are identified. They must meet the norm, otherwise the doctor may prescribe treatment. The course of pregnancy and childbirth depends on the correctness and timeliness of therapy.

Main indicators of hemostasiogram:

Coagulogram norms during pregnancy

Blood clotting during pregnancy: deviations

Increased blood clotting is manifested by the following symptoms:

Therapy for increased blood clotting is carried out with anticoagulants. Consumption gives good results sufficient quantity liquids (1.5-2 liters per day), balanced diet, inclusion in the diet olive oil, seaweed, garlic, bell pepper and nuts.

Poor blood clotting (thrombocytopenia) is manifested by the following symptoms:

• frequent nosebleeds;
• formation of bruises on the body;
• bleeding gums.

If there is poor blood clotting, it is advisable for a pregnant woman to avoid eating foods rich in ascorbic acid. To strengthen blood vessels You can drink rosehip tincture, and also eat lemons with peel and honey.

Both increased and poor clotting blood during pregnancy can lead to dangerous consequences. If you notice unusual symptoms, you should immediately consult a doctor and follow his recommendations.

The period of bearing a child is a serious test for female body Therefore, during pregnancy, the expectant mother undergoes numerous tests and tests. Once a woman becomes pregnant, it is important to monitor her well-being before giving birth.

Monitoring blood counts is one of the main studies that makes it possible to monitor the health of the woman and the fetus. And if violations are detected, due to the frequency of tests performed, the likelihood of successful treatment is high due to timely diagnosis.

The indicator that doctors pay attention to is blood clotting. The norm for women during pregnancy is different stages changes, which does not always mean pathology, but needs control.

Clotting in medicine is called coagulation. Coagulation is an enzymatic protective reaction of the body, activated to stop bleeding in the event of a violation of the integrity of vascular tissues. Without the help of this defense mechanism the injury threatens the person with bleeding, even death.

The coagulation mechanism is divided into 2 types:

• Primary hemostasis. Its activation occurs when small-diameter vessels are injured. The formed elements of blood, known as “platelets,” help to bridge the gap in the wall. By sticking together, these cells form a thrombus, which clogs the destroyed part of the epithelium of the vessel. At the same time, rapid contraction of the damaged tissue occurs. The second name of the mechanism is vascular-platelet hemostasis.
• Secondary hemostasis is known as “coagulation”. The process is noticeably more complicated and consists of several stages. Its activator is volumetric damage. During coagulation hemostasis, under the influence of enzymes, fibrin filaments are formed from a substance found in the blood - fibrinogen. The threads form a network that traps formed blood cells, the main part of which are red blood cells, and a blood clot forms.

High coagulation rate during pregnancy

To be able to judge high level blood clotting during pregnancy, you need to know about the normal rate for a woman during this period. Already at the beginning of the second trimester, changes occur in the body of the expectant mother. physiological changes, the result of which is increased synthesis of substances that regulate the formation of blood clots.

This transformation is aimed at preparing the female body for upcoming birth. Thanks to the care of nature after childbirth, the vessels located at the placenta separation site are able to tighten, saving the woman from blood loss.

An analysis indicating clotting during pregnancy, which a woman will have to do more than once, makes it possible to notice disruptions in this important process in time. The decoding of the study must be entrusted to a qualified specialist. Fluctuations in the standards of basic coagulation parameters can be found in the table below.

A blood test indicating high coagulability during pregnancy is a bad sign and signals the risk of a condition called hypercoagulability.

Increased blood clotting during pregnancy: what is dangerous?

Hypercoagulation threatens the patient:

• Late toxicosis.
• Problems in child development.
• Premature placental abruption.
• Risk of miscarriage.
• Death of a child.

Symptoms of hypercoagulation are increased fatigue, drowsiness and headaches resulting from decreased oxygen supply to the brain. Possible disorders in the functioning of the intestines and other internal organs.

Clotting test: what is it called?

During a woman's pregnancy, doctors constantly conduct blood tests to help monitor the dynamics of the expectant mother's condition. An analysis that informs about the level of coagulation is called a “coagulogram”.

Attention! If the results of the study show that the indicator is higher than normal, the woman is at risk of activation of intravascular coagulation during pregnancy or DIC syndrome, meaning disseminated intravascular coagulation.

At risk are women who become pregnant before the age of 18 or after 40, with diabetes mellitus, pathologies of the kidneys and cardiovascular system, patients who had hypercoagulation before planning pregnancy. It is especially important for them to get tested periodically.

Treatment of hypercoagulability

If you are diagnosed with high blood viscosity, you will need to use medications called anticoagulants. It depends on the nature of the disease whether anti-inflammatory drugs and antispasmodics will be needed. In case of complications, surgical removal of blood clots is allowed.

Important! The use of medications that have a thinning effect while carrying a child is fraught with consequences such as bleeding. For this reason, taking any drug should be discussed with your doctor.

Changing your usual diet and eating pattern helps to reduce viscosity to some extent. A woman is advised to drink 1.5-2 liters of clean drinking water during the day. The list of liquids should include green or herbal tea, juices from vegetables and fruits (give preference natural juices).

As for products, eating seaweed and fish, onions and garlic will have a positive effect. Nuts and olive oil are beneficial for the expectant mother. linseed oil. Remember that the condition of the child depends on the health of the mother.

More:

Causes, diagnosis and treatment of increased blood clotting Plasma and cellular factors involved in the blood clotting process

The expectant mother undergoes blood tests with enviable frequency. Of course, if some indicators differ from the norm, the question arises - why is this happening, what does it mean, and can it somehow affect the child’s health? One of the common problems is a violation of blood clotting during pregnancy in one direction or another.

Why does the body need a blood coagulation system (hemostasis)? It allows us to avoid large blood loss if the vessels are damaged. In practice, everyone is familiar with this phenomenon: if a person, for example, cuts himself, then gradually the blood from the wound flows more and more slowly, and then stops and a blood clot forms at the site of the cut. But the blood in the body must be liquid in order to circulate - and therefore, in addition to the coagulation system, we also have an anti-coagulation system.

During pregnancy, the volume of blood circulating in the mother's body increases significantly - by 25-50% of the initial level. The coagulation system must work to ensure uteroplacental and fetal placental blood flow. To clarify the operation of the system, a special analysis is performed - a hemostasiogram.

What are the norms for blood clotting during pregnancy? Doctors will look at the following hemostasiogram indicators:

• APTT is normal 24-35 seconds. This is the time of blood clotting;
• Prothrombin is normal 78-142%. The indicator is responsible for the quality of blood clotting;
• TV (thrombin time) is normally 11-18 seconds. Time of the last stage of clotting;
• Antithrombin III is normal 71-115%. This protein inhibits clotting processes;
• Fibrinogen – 2-4 g/l, by the end of pregnancy – up to 6 g/l;
• D-dimer – less than 248 ng/ml. This indicator is a marker of the presence of increased blood clotting;
• RKMF and lupus coagulant are normally absent.

What do deviations from blood clotting norms mean during pregnancy? They indicate the possibility of disruption of placental blood flow or the risk of bleeding during childbirth. Let's look into this a little more.

Increased blood clotting during pregnancy

Thick blood can be seen even at the stage of taking a blood test. A hemostasiogram will confirm or deny the presence of this problem. The danger of increased coagulation lies in the occurrence of DIC syndrome (disseminated intravascular coagulation). Placental blood flow is disrupted, which means that the fetus does not receive the nutrition and oxygen it needs.

The baby in the womb may be delayed in development, and in severe cases, even termination of pregnancy is possible. The risks of developing disseminated intravascular coagulation syndrome and increased blood clotting during pregnancy increase if a woman has had heart attacks or strokes, varicose veins, thrombosis in her family, or if the previous pregnancy was not carried to term (miscarriage or cessation of its development). Redundant physical exercise before pregnancy (for example, professional sports) can also become a provoking factor.

How to fix the situation? If the blood is too thick, doctors will recommend that the expectant mother change her diet. Be sure to drink a lot of water, and also eat foods containing a large supply of vitamin C. Light exercise will also not hurt.

In addition to diet and exercise, the woman may be prescribed special therapy medicines, blood thinners - in tablet or injection form.

What if the blood is too thin?

The exact opposite problem is low blood clotting during pregnancy. A woman may independently notice some of the symptoms of poor clotting. This is the occurrence of bruises and hematomas even with minor injuries, nosebleeds, bleeding gums.

Doctors identify several factors that contribute to the occurrence and development of low clotting. If this is not associated with congenital diseases of the circulatory system, then taking certain medications can negatively affect the situation - for example, from varicose veins veins In relation to varicose veins, they, of course, work well - but in general, all blood gradually loses its ability to form blood clots. In addition, uncontrolled use of non-steroidal anti-inflammatory drugs, which include the well-known analgin, aspirin or baralgin, is also dangerous.

Finally, work on hazardous production or poor ecology can also negatively affect the functioning of the blood coagulation system.

Low blood clotting during pregnancy is dangerous due to the occurrence of profuse bleeding during childbirth, as well as a high probability of placental abruption - and, as a consequence, premature birth. Needless to say, if planned C-section, is poor clotting also extremely dangerous? 5 out of 5 (21 votes)