APTTV: the norm. APTTV during pregnancy: norm
APTTV stands for activatedpartial thromboplastin time. This indicator refers to the study of the blood coagulation system and reflects the internal and general way of coagulation, ie, this is the time it takes to form a blood clot. This test is included in a study called coagulogram, which more thoroughly studies the coagulation system.
Blood test for APTT: norm
In this study, the time requiredon clot formation. When testing blood on the APTT, the norm in a healthy person is between 25 and 40 seconds. If other clotting factors (prothrombin, INR, fibrinogen, etc.) change, then the APTT parameter reacts sharply to this. The norm of APTT in the blood of pregnant women is 17-20 seconds.
Why is a study assigned to a pregnant woman assigned to APTTV?
During pregnancy in the body of a womana number of physiological changes occur. This also applies to blood clotting. The blood of a pregnant woman often becomes more dense. The reason to prescribe a coagulogram study is a change in the general blood test, which, after registration for pregnancy, the woman gives regularly.
If the total blood test showed an increaseshaped elements, this can mean a thickening of the blood, and there is an occasion to prescribe a coagulogram that includes the analysis of the APTT. The rate of this indicator for pregnant women is slightly different and amounts to 17-20 seconds. This is due to the gradual increase in fibrinogen during pregnancy, which at the time of delivery reaches a value of 6 g / l, while in healthy people it is normally between 2.0 and 4.0 g / l.
In the body of a pregnant woman, certain processesare not active, this also applies to hemostasis. This is normal, but deviations from the norm do happen. To avoid possible negative consequences for the child and mother, a coagulogram is prescribed.
What studies are included in the coagulogram?
Coagulogram research can be basic and advanced. The basic study includes the following parameters:
- Prothrombin (PTH - prothrombin index).
- INR (International Normalized Ratio, i.e., Standard for Determining Coagulation).
If necessary, additional parameters can be assigned:
- Protein C - with its lack of a high probability of thrombosis.
- Antithrombin refers to the anticoagulation system, and its deficiency can also lead to thrombosis.
- D-dimer - released when the blood clot is broken. Its increased number indicates the formation of blood clots in the bloodstream.
- Lupus anticoagulant.
- ATS (activated calcification time).
- Time of plasma recalcification.
- Plasma tolerance to heparin.
- RFMK (soluble fibrin-monomer complexes).
What do the coagulogram indicators say?
The index of APTT during pregnancy (norm 17-20 sec.), fibrinogen and other parameters, especially at the latest times, are of great importance for the prevention of complications. Thus, an increase in PTI (prothrombin) above 150% may indicate abruption of the placenta. It is very dangerous for the life of the future mother and her child.
D-dimer should normally not be more than 248 ng / ml. This is for healthy people. During pregnancy, its rates increase. By the end of pregnancy can be above the initial value of 3-4 times. This is the norm. The increase in D-dimer more than 4 times from the initial value may indicate a serious pathology - gestosis, and also occurs in pregnant women with diabetes mellitus or severe kidney disease.
One of the many causes of miscarriagepregnancy and miscarriages of different periods is AFS (antiphospholipid syndrome), which is characterized by the formation of arterial and venous thrombosis. To establish such a diagnosis, antibodies to the outer membrane membrane (phospholipids), as well as fibrinogen, D-dimer, prothrombin, and APTTV values are determined. In pregnancy, their norm differs from the normal indices of healthy people.
Why is the homeostasis system activated during pregnancy?
The main reasons for this activation are as follows:
- During pregnancy, the hormonal background of the body changes.
- There is an additional circle of blood circulation - utero-placental.
- The woman's organism is preparing for the inevitable blood loss during labor.
Thick blood - what to do?
If during pregnancy studiesshow that the blood is thick, just do not panic. Most likely, the doctor will prescribe a corrective diet. First of all, the salt and all the salted foods (sausages, smoked products, pickled cucumbers, etc.) should be excluded from the diet. From fatty foods is also better to give up. Instead, eat more vegetables, berries and fruits of red and orange. They are more rich in vitamin C than others, which can dilute blood.
It is useful to include in the diet the following products:
- berries (raspberries, black and red currants,mulberries, plums, strawberries, cranberries, sea buckthorn, Kalina), but one should be careful with the use of raspberries and viburnum - these berries can not be consumed in large quantities by pregnant women;
- citrus fruits (tangerines, oranges, lime, lemon, grapefruit);
- dried apricots;
- a pineapple;
- onion and garlic;
- Birch juice;
- chocolate and cocoa;
- vegetable oils (rapeseed, olive, linseed);
- spices instead of salt (turmeric, curry, oregano, paprika, dill, cayenne pepper, ginger, thyme, cinnamon).
Products that can condense blood should be completely eliminated. These include: bananas, potatoes, buckwheat, all fizzy drinks and alcohol.
You need to drink at least 1.5 liters of water a day. But the water must be drinkable and without gas.
One of the most dangerous complications in obstetricpractice is considered DIC-syndrome (deseminirovannoe intravascular coagulation). At the initial stage, there is hypercoagulation (increased coagulation), which is then replaced by hypocoagulation (a decrease in coagulation capacity), which leads to massive blood loss and life threatening. DIC-syndrome often acquires uncontrolled flow, and then it can lead to the death of the woman and her baby.
To avoid this situation,research of coagulogram with mandatory determination of fibrinogen, PTI, APTTV, the norm of which during pregnancy is 17-20 seconds. Usually such examination, if there was no history of complications of previous pregnancies, is prescribed in each trimester. Such studies are made unscheduled in those cases if:
- At least one of the previous pregnancies ended in a miscarriage.
- There is symptomatology of gestosis - the presence of protein in the urine, swelling of the extremities, hypertension.
- There is a threat of miscarriage, for example, with hypertension of the uterus.
How do I take a blood test for a coagulogram?
Blood for such research is taken from the vein in the treatment room in the morning on an empty stomach. Pregnant women do this in a women's consultation. For reliable indicators it is necessary to observe several simple conditions:
- The last meal should be no later than 10-12 hours before the test.
- It is not recommended to take any medications before giving blood. If the patient takes medications that affect the coagulation system, this should be indicated in the direction.
- It is not recommended to drink before giving blood blood coffee, tea, sodas and especially alcohol. You can drink only a glass of clean drinking water.
- Emotional state can also influence the result, so it's better to sit in front of the office for a few minutes and calm down.
- Muscular overstrain may distort the results of the analysis, therefore it is not recommended to visit gyms and do heavy physical labor just before giving blood and the day before.
For the APTT rate, the norm in women and menis between 25 and 40 s. On the basis of sex, it does not differ, only during pregnancy it decreases slightly. Interpretation of the results of the study is carried out only by specialists.
How much is?
Pregnant women's consultation givenThe study is usually done free of charge provided there is a stamped referral from the doctor. All other citizens, if they wish, can pass such a research fee. Extended coagulogram costs about 3500 rubles. The basic parameters will be cheaper - from 700 to 1300 rubles.
What does the APTTV show below the norm?
In a survey of a coagulation system, one of theThe main parameters are the APTT index. Its rate is from 25 to 40 seconds. Recall, this parameter shows the time it takes to completely coagulate blood and form a blood clot. If this indicator is below 25 seconds, this fact may indicate a thickening of the blood and the risk of thrombosis. In pregnant women, for APTTV, the norm is 17 to 20 seconds. Usually, this condition during pregnancy does not require treatment and passes after delivery. In addition, a few thicken the blood can iron preparations, which are often prescribed to pregnant women with low hemoglobin figures.
What is the increase in APTTV?
The APTT indicator above the norm cantestify to the presence in a person of a disease such as hemophilia, serious liver disease, such as cirrhosis, or a lack of vitamin K. In addition, an increase in this parameter is observed in the following cases:
- With a lack of coagulation factors.
- In the case of treatment of the patient with anticoagulants, for example, "Heparin" or "Warfarin."
- With hereditary blood diseases, such as von Willebrand disease.
- With DIC-syndrome.
Such a study of a coagulation system, like a coagulogram, is useful not only for pregnant women, but for all people. In case of any abnormalities, you need to see a doctor.