Coagulation and its main components
Coagulation - the study of coagulationblood system. Coagulation reveals features of bleeding disorders in pregnant and some complications of pregnancy and, therefore, to carry out the proper treatment.
In the normal course of pregnancy increasesthe activity of the blood coagulation system. This is a natural process associated with the emergence of utero-placental circulation. Driven by he fact that the body of a pregnant preparing for the increase in blood volume during childbearing and to potential blood loss during delivery.
Coagulogram should take every trimester, andin the presence of abnormalities of hemostasis indicators (set of blood vessels and blood components, the interaction of which maintains the integrity of the vascular wall and stop bleeding when damaged blood vessels) - more often prescribed by a doctor.
Blood analysis is taken from a vein in the morning on an empty stomach.
Here are some parameters of coagulation:
- Fibrinogen - protein precursor of fibrin,is the foundation of a clot in blood coagulation. Fibrinogen - is a sensitive indicator of the presence of inflammation and necrosis (necrosis) of tissue, the main plasma protein that affects the value of ESR (erythrocyte sedimentation rate). It increases with increasing fibrinogen concentrations. During pregnancy, starting from the end of the first trimester, there is a natural increase in plasma fibrinogen content and reaches maximum values before birth. This is due to the appearance of additional circulation - Uteroplacental.
- APTT - activated partial thromboplastintime. This clotting time, which depends on the presence of clotting factors. Determination of APTT, along with other indicators used in the diagnosis of disseminated intravascular coagulation (DIC), which is said below. Pregnant marked shortening of aPTT due to the increased amount of fibrinogen.
- Thrombin time (TV). It is the last stage of blood coagulation is the formation of fibrin from fibrinogen by thrombin. Given that increases in fibrinogen pregnancy therefore lengthens the thrombin time but remain within the specified limits. Definition TV is used in order to identify defects in production of fibrinogen (eg, fibrinogen may rise in liver disease) and evaluation of anticoagulation activity.
The mechanism of blood coagulation
The process of blood coagulation comprises severalstages. In the first stage by mechanical or chemical damage to the blood vessel wall is allocated a special substance - thromboplastin, triggering clotting reaction.
Platelets - blood cells it. Platelets are formed in the bone marrow. A moderate decrease in platelet count can sometimes be observed in healthy pregnant women. Thrombocytopenia - a significant reduction in the number of platelets - may occur as a result of reduction of platelet formation, improve their destruction or consumption. platelet formation decreases with malnutrition. platelet consumption increases with DIC.
In contrast to the coagulation system in the body works anticoagulation system. Well coordinated work of these systems makes it possible to maintain normal blood.
DIC as a complication of pregnancy
Coagulogram should take every trimester, and if there are abnormalities of hemostasis - often prescribed by a doctor.
The balance between coagulation and anticoagulationsystems supported by the interaction of platelets, coagulation factors and fibrinolysis process. Violations affecting any of these units can cause serious complications in pregnancy. Among the most dangerous complications is DIC (disseminated intravascular coagulation). This syndrome develops due to the activation of the coagulation system - on the one hand, and fibrinolysis systems - on the other.
DIC in pregnant women can be caused by many things. Among them:
- premature detachment of the placenta - abruptionnormally situated placenta before birth. In 80% of cases the disease is accompanied by bleeding from the genital tract, sometimes formed a hematoma behind the placenta. Bleeding associated with a decrease in the plasma concentration of coagulation factors, platelets and fibrinogen;
- amniotic fluid embolism - a rare but dangerouscomplication develops complications during birth, due to receipt of amniotic fluid in the mother's blood stream, lungs, blood vessels, which leads to acute respiratory failure and shock. DIC develops as a result of the massive revenues into the bloodstream tissue thromboplastin - the substance that triggers the process of blood clotting;
- Dysmenorrhea - inflammation of the inner lining of the uterus - to develop after birth, may be complicated by lightning form of DIC.