Coagulogram is an analysis performed for the study of blood coagulability. The primary study is called the baseline, and if a pathology is found, an extensive examination is already conducted. Identified by the analysis of indicators allow you to know the status of hemostasis. Increased coagulability may indicate a risk of thrombosis, and reduced coagulability provokes bleeding.
A complete assessment of the coagulogram is performed according to numerous factors of coagulation. Without this, the analysis is considered indicative. So, what is this analysis, coagulogram, what it includes, what it shows during pregnancy, where the blood is taken for it - all the answers to all the questions you will find in this article.
To whom it is prescribed
A coagulogram is prescribed if there are indications listed below. It is especially important in pregnancy, so women in the position of her spend most often. For ordinary people, the procedure is required before surgery and in the presence of cardiovascular pathologies.
The person who is assigned and how the coagulogram is administered will be described by the specialist in the following video:
Why go through the procedure
The data obtained at the time of the analysis helps to identify all disorders that arise in homeostasis. Some deviations are quite normal, but sometimes they indicate the development of diseases in the body. Pregnant women with a coagulogram determine the risk of miscarriage, which helps in time to neutralize disastrous consequences.
Women in the position are required to undergo this analysis every trimester of their pregnancy. However, it is possible and unplanned appointment of hemostasiograms in cases where:
- there is hypertension of the uterus;
- there are signs of gestosis( puffiness, protein in the urine, high blood pressure);
- previously there were miscarriages.
For ordinary people, a coagulogram is usually performed to exclude the likelihood of any disease. Patients with cardiac problems are required to study more often, and the doctor appoints him at his own discretion.
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Types of coagulogram
Hemostasiogram is divided into basic( indicative) and unfolded.
- In the first case, the analysis only reveals the presence of violations in the hemostasis.
- In the second case, a full study is carried out to establish the cause of this phenomenon and to delineate the pathologies of hemostasis from diseases with a similar effect. Along with this, a quantitative and qualitative assessment of such violations is carried out.
Indications for
Coagulogram is required in a number of cases:
- In liver diseases.
- During the period of hirudotherapy.
- The presence of autoimmune pathologies.
- Pregnancy. The study is usually conducted every trimester, which allows you to immediately detect changes occurring in the body. The frequency of the coagulogram increases if gestosis or fetoplacental insufficiency is detected.
- Reception of contraceptives. The study is done at least every 3 months.
- Blood clotting disorders.
- Cardiac pathology.
- Scheduled operations.
- Before the appointment of acetylsalicylic acid and its constituents.
- Vascular disorders.
About the indications and contraindications to the coagulogram will tell the specialist in the continuation of the previous video:
Contraindications for Conducting and Safety of
There are no contraindications for the procedure. Coagulogram is safe for any category of patients.
Preparing for
Preparation for haemostasiogram is a prerequisite. They refuse to eat before the test, so the last time you can eat can be done only 8 hours before the procedure( preferably 12 hours). Be sure to exclude alcohol, coffee, soda and any other similar beverages. Use only clean water.
Before starting the procedure, the doctor should be warned about the preparations that are being taken at this time. This particularly applies to medications that affect the process of blood clotting. It is important to keep a calm, balanced state, not to overexert physically. It is not superfluous to drink a glass of cool water in front of a coagulogram.
On how to donate blood to the coagulogram analysis, read below.
How everything passes
Blood is drawn from a vein or a finger. The laboratory assistant( after disinfection of devices and the place of taking blood) should puncture the skin area least traumatically, in order to prevent distortion of the results due to the ingress of tissue thromboplastin particles into the analysis. At the time of taking the blood, to exclude this possibility, the lab technician fills 2 tubes with material, sending only the latter to the study. For the collection of blood from the vein does not require the use of a tourniquet, and a special coagulant is placed in the tube.
At the time of the procedure, unpleasant sensations are related only to the prick of the skin and the penetration of the needle. After gemostaziogrammy in the limb, from which the blood was taken, there may be a slight weakness. About the decoding of the blood coagulogram in adults, the indices of the norm, we will tell below.
Decoding of the results
The coagulogram must be deciphered by the indices. What do they mean?
- ACTTV .It is a study of time that is spent on the formation of a blood clot. The norm is 30-40 seconds. If the period is spent more, it can talk about liver disease, a lack of vitamin K or hemophilia.
- Lupus anticoagulant .An optional indicator, therefore, is investigated only if there are suspicions of autoimmune pathologies. Often, they also show an increase in APTT.In a complex this confirms the presence of an autoimmune disease.
- Prothrombin .It is a protein that under the influence of vitamin K is formed into thrombin. Deviations from normal values indicate a worsening of the liver and digestive tract.
- Fibrinogen .Synthesis of this enzyme occurs in the liver, and the normal values are figures from 2 g / l to 4 g / l. At pregnant women the top indicator in the last period of pregnancy should and at all make 6 g / l. This enzyme is sensitive, so changes of this factor towards the decrease indicate the DIC syndrome, hepatitis, toxicosis, liver cirrhosis, lack of vitamins. Sometimes this phenomenon is also the result of taking certain medicines. The increase in fibrinogen can provoke tissue necrosis, hypothyroidism, inflammation, the initial stage of myocardial infarction development, burns, infection, and contraceptive use.
- Thrombin time shows the period of synthesis in the fibrin of the fibrinogen protein. The norm is 11-18 seconds. Thrombin time may be higher during pregnancy. If abnormalities are detected, you can talk about an excess or a lack of fibrinogen.
- Prothrombin time .This is the period of transformation of the inactive form of the protein( prothrombin) into the active( thrombin).It is thanks to this enzyme that a clot that stops bleeding is formed. At high rates, liver pathologies, lack of coagulation factors or hypovitaminosis are diagnosed.
- Platelets of are the main cells needed to support hemostasis. The normal indices are 150000-400000 μl. When deficiency is diagnosed thrombocytopenia.
- Prothrombin Index( PTI) .This is a comparison between the established norm of coagulation of blood plasma and the parameters obtained from the patient. The indicator is expressed as a percentage. The normal figures are the figures 97-107%.Low values indicate deterioration of coagulating properties, intestinal diseases or vitamin K deficiency. Sometimes such influence is achieved by taking diuretics and acetylsalicylic acid. The change in PTI indicates the likelihood of thrombosis, liver disease.
- D-dimer are the remains of a fibrin fiber enzyme. This indicator is very important in studies during pregnancy. The general norm is 500 ng / l, but for women in the situation, its excess is several times higher. Excess D-dimer sometimes indicates diabetes mellitus, preeclampsia, kidney disease.
- Antithrombin III .The increase indicates a serious risk of thrombosis.
- DIC-Syndrome .The clotting system in the body works very intensively, which leads to its development. In pregnant women, this can cause endometritis, placental abruption, embolism with amniotic fluid.
- The plasma recalcification time outlines the entire process of coagulation as a whole.
- Antibodies to phospholipids .This autoimmune pathology can cause fetal loss due to fetoplacental insufficiency. In the body more and more antibodies appear, which can provoke a number of signs characteristic for thrombosis of the arteries and veins.
- Plasma tolerance to heparin. To conduct the test and identify relevant indicators, heparin, obtained during the investigation of the recalcification time of plasma, is used. With a decrease in tolerance, hepatitis or cirrhosis is suspected, and with an increase in heart failure, tumors of malignant genesis, prethrombosis are often diagnosed.
It is not necessary to study the coagulogram independently, since the expert takes into account a lot of factors when decrypting the data.
The table below shows the blood coagulation rate in pregnant women:
| Thrombin time | 11-18 sec. |
| Activated partial thromboplastin time | 17-18 sec. |
| Fibrinogen | 6 g / l |
| Prothrombin | 78-142% |
The price of a blood coagulogram is discussed further.
Average cost of
The cost of a blood coagulogram depends on the equipment and volume of services. For example, a basic study can cost between 700 and 1500 rubles, and an extended one - 3500 rubles.
Pregnant women under the MHI policy do not pay for haemostaziogram, since this examination is a mandatory category for them.
The importance of conducting a coagulogram during pregnancy will be told by specialists in the video below: