Re-analysis of the coagulogram is given after how many days. Coagulogram - what kind of analysis, decoding, norm. How it is carried out and how to prepare

A hemostasiogram (coagulogram) is a blood test performed to determine the level of its coagulation. Deciphering the blood hemostasiogram is of great importance in the process of preparing the patient for surgery. It helps to prevent possible complications such as bleeding and thrombosis. The study of coagulation is certainly carried out during the passage of pregnancy, and if there is a history of diseases of the vessels, heart and liver. The presence of autoimmune diseases is also an indication for a blood hemostasiogram. The analysis makes it possible to determine the cause of bleeding.

General information

The hemostasis system (blood clotting) protects the patient from dangerous blood loss during violation of the integrity of the walls of blood vessels against the background of surgical interventions and traumatic injuries. The endocrine and nervous systems are responsible for normal hemostasis in the body. In order for the blood to adequately perform its main functions (regulation of body temperature, supply of tissues with nutrients and oxygen), it must have normal rheological properties, that is, fluidity.

Reduced coagulation (hypocoagulation) against the background of various pathologies can lead to blood loss, which is life-threatening. This condition is the cause of the appearance of blood clots (blood clots) that close the lumen of the vessels. As a result of thrombosis, tissue ischemia is formed, which leads, among other things, to strokes and heart attacks.

The main elements of the hemostasis system:

plasma factors;
platelets;
endothelial tissue of the vascular wall.

Blood is collected from a vein in the area of the elbow bend. In order to prevent misinterpretation and distortion of the results, it is necessary to prepare for the examination carefully.

If a person takes pharmacological anticoagulant drugs, then he must tell the doctor about it. If during the blood sampling for examination of the coagulogram, a fainting state begins to appear or dizziness develops, then it is necessary to immediately notify the doctor.

Indications and method of analysis

Indications for a coagulogram are as follows:

previous strokes and heart attacks;
high tendency to thrombosis;
liver disease;
vascular diseases;
preparation for surgery;
pregnancy.

Blood is taken with a syringe or using a vacuum system. The tourniquet is not applied to the arm. The puncture must be atraumatic in order to prevent data distortion due to the ingress of a significant amount of tissue thromboplastin into the collected material. Two test tubes are filled with blood, but only the second is used to perform the analysis. In a sterile test tube is an anticoagulant - sodium citrate.

Norms and interpretation of the coagulogram

During a standard analysis for a coagulogram, a large number of indicators are determined, which are evaluated in aggregate.

The prothrombin index (PTI) reflects the ratio of the duration of blood clotting in the norm to the duration of clotting in a patient. Variants of the norm (reference values) - 96−100%. In pregnant women, this figure is increased (up to 120% or more), this is not a pathology. PTI indicators make it possible to determine the absence or presence of liver diseases. The index increases against the background of the use of hormonal contraceptives. An increase in indicators relative to the norm indicates the risk of thrombosis, and a decrease indicates a possible bleeding.

In order for the prothrombin index to be normal, the body needs a regular intake of vitamin K.

Clotting time is the time interval between the onset of bleeding and its completion with the formation of a fibrin clot. Venous blood coagulates in 7-12, and capillary blood in 0.7-4 minutes. The duration of bleeding increases against the background of hypovitaminosis C, thrombocytopenia, taking drugs from the group of indirect anticoagulants (including Warfarin, Trental and acetylsalicylic acid), liver diseases and hemophilia. The duration of clotting is reduced after heavy bleeding, and in women - and against the background of the use of oral contraceptives.

Activated partial thromboplastin time (APTT) is a value that reflects the duration of clot formation after addition of calcium chloride (CaCl2) to plasma. Normal readings are approximately 35-45 seconds. Changes occur during the deviation of other indicators of the coagulogram in the range of 35%. The lengthening of this time interval may indicate hypovitaminosis K or liver disease.

Thrombin time measures the rate at which fibrinogen is converted to fibrin. The norm is 14-19 seconds. A decrease in this period of time with a high degree of probability indicates an excess of fibrinogen, and its increase indicates a functional severe liver failure in cirrhosis, against the background of hepatitis, or an insufficient concentration of this protein compound in the serum.

Constant monitoring of this coagulogram value is very important during heparin treatment.

Plasma recalcification time (PRT) is the value of the coagulogram, which correlates with AVR and reflects the time interval of coagulation of citrate serum with calcium salt preparations. The norm is 1.5-2 minutes. Reducing the time indicates a high activity of hemostasis.

Activated recalcification time (ART) in healthy people is approximately 40-60 seconds. This value helps to determine the passage of one of the stages of coagulation. A decrease in ABP is a symptom of thrombophilia, and an increase is noted with the use of anticoagulants (heparin), thrombocytopenia, the development of shock, extensive burns and serious injuries. A lower AVR value indicates an increased risk of massive bleeding.

In a healthy person, the amount of fibrinogen is 6-12 µmol/l. Its decrease occurs during liver problems, and its increase occurs with hypothyroidism and malignant neoplasms.

The amount of fibrinogen during the absence of diseases is in the range of 2.5–4.5 g/l. This protein compound is formed in the liver, and is transformed under the influence of coagulation factors into fibrin, its threads are the main structure of blood clots.

If the coagulogram shows a significant decrease in value, this may be a symptom of such pathologies:

severe liver disease;
violation of hemostasis;
lack of ascorbic acid and hypovitaminosis of group B;
toxicosis during pregnancy.

The level decreases against the background of the use of fish oil, as well as in the treatment of anabolics and anticoagulants.

An increase in the amount of fibrinogen is observed with significant burns, hypothyroidism, acute infections, acute blood circulation disorders (heart attacks and strokes), against the background of hormone therapy, postoperative interventions, and in women - during pregnancy. Normally, Fibrinogen B is not detected.

Fibrinolytic activity is the value of the coagulogram, which reflects the ability of human blood to dissolve blood clots that have appeared. The component of the anticoagulant system, fibrinolysin, is responsible for this function in the body. During its increased concentration, the time for the dissolution of blood clots increases, thus, bleeding increases.

Soluble fibrin-monomeric complexes (SFMK) show a change at the molecular level in the protein structure of fibrin under the influence of plasmin and thrombin. Normal is an indicator that does not exceed 5 mg / 100 ml. The variability of this value is explained by the same reasons as the change in the amount of fibrinogen.

RFMK is a marker, which makes it possible to take timely measures to prevent the occurrence of DIC.

Plasma tolerance to heparin. The norm is - 8-17 minutes. The analysis makes it possible to determine the amount of thrombin in the blood. A decrease in the value with a high degree of probability indicates liver diseases. If the time interval is less than 8 minutes, then the presence of malignant neoplasms or cardiovascular pathologies can be suspected. Hypercoagulability is often observed in the state of postoperative interventions and in late pregnancy (third trimester).

Thrombotest makes it possible to visually determine the amount of fibrinogen in the examined material. In the normal state, this is a stage 3-5 thrombotest.

Duke bleeding time- this is a separate analysis, during which capillary blood is examined, and not venous. The pad on the finger is pierced 5 mm deep with a lancet. The blood that has come out from the puncture is removed with a special piece of paper every 20-35 seconds (without touching the skin). After each removal, the time until the next drop appears. The time of completion of bleeding from the vessels in a healthy person is 1.5-2 minutes. This indicator, in particular, is affected by the content of the mediator serotonin.

Retraction of a blood clot is expressed by a decrease in its quantity and complete separation from the plasma. The normal rate is 44−60%. An increase in the indicator is noted in various forms of anemia, and a decrease is the result of erythrocytosis.

Features of the coagulogram in children

In children, the indicators of the norm of the coagulogram are very different from the norm in adults. Thus, in newborns, the normal amount of fibrinogen is 1.3-3.5 g / l.

Indications for a coagulogram in children:

upcoming surgery;
diagnosis of diseases of the hematopoietic system;
suspected hemophilia.

Coagulogram during pregnancy

During pregnancy coagulogram produced at least three times (in each trimester).

During pregnancy, hemostasis parameters normally change, this is caused by hormonal changes in the woman's body, the appearance of the uteroplacental circle and an increase in the total amount of circulating blood.

In the first trimester, the clotting rate increases significantly, and in the third it greatly decreases, thus providing the woman with protection from possible blood loss during delivery. The coagulogram makes it possible to determine the threat of premature birth or spontaneous abortion as a result of the formation of blood clots. Disorders in the coagulation system of a pregnant woman adversely affect the central nervous system of the unborn baby.

Mandatory analysis of the coagulogram is required if a woman has vascular disease or liver failure is determined. The coagulogram is also examined with a negative Rh factor and a decrease in immunity.

Normal indicators of individual coagulation values in pregnant women:

APTT - 18−22 seconds.
thrombin time - 12−19 seconds;
prothrombin - 80−140%;
fibrinogen - 7 g/l.

Deviation in the amount of prothrombin from the norm can talk about placental abruption.

Blood clotting is a reliable defense mechanism of our circulatory system. A large number of diseases and pathologies of different organs can affect its work. Therefore, monitoring the normal functioning of hemostasis by determining the coagulogram is a reliable way to diagnose many diseases and prevent possible complications.

- This is an analysis that is often prescribed by doctors of various specialties, so it is familiar to most people. Blood for a coagulogram must be taken without fail if there are serious diseases of the heart and blood vessels or surgery is planned. Also, a coagulogram is performed every trimester for pregnant women.

Coagulogram is the most commonly used term, but this analysis has another name - hemostasiogram. The study is aimed at assessing the coagulation abilities of the blood. The basic coagulogram is prescribed at the first stage of diagnosis. If the doctor sees any deviation from the established norms, he refers the patient to an extended study. It allows you to assess the existing violations, not only qualitatively, but also quantitatively.

What is a coagulogram?

In order to answer this question most fully, one should start with the mechanism of blood coagulation. Why is it needed? Let's say a person accidentally cuts himself. At the same second, a complex and very important process begins to occur in the focus of tissue damage - the formation of blood clots - blood clots, with the help of which the body “seals” the wound in order to avoid blood loss. We are accustomed to perceive a quick stop of bleeding as something natural and self-evident, meanwhile, even the slightest disturbances in the work of the coagulation system threaten us with fatal consequences.

The thing is that during our life our body has to stop bleeding many times: large and small, superficial and internal. The mechanism of hemostasis works not only under extreme conditions (wounds, burns), but also under quite ordinary circumstances, such as menstruation or a local inflammatory process that damages small vessels and capillaries.

If blood did not have the ability to clot, normal life would simply be impossible, not to mention coping with a serious injury, illness or surgery. And in order to evaluate the work of the hemostasis system, a coagulogram is just what is needed - the norms for adults, children and pregnant women in the table will be presented to your attention further.

In addition to insufficient activity of the blood coagulation system, there is also excess, which is no less dangerous to health. Unnecessarily formed blood clots can clog important blood vessels, which will lead to oxygen starvation or even necrosis of individual organs and body parts.

Let's now understand in detail what the blood coagulation system consists of:

First component- These are flat cells of the endothelium lining the inner surface of the vascular walls and cavities of the heart. When these cells are irritated as a result of violation of the integrity of the vessel, they begin to produce biologically active substances: nitric oxide, thrombomodulin, prostacyclin. The blood reacts to these compounds and begins to clot;

Second component are platelets, which are called platelets and are one of the most important components of blood. They have a unique ability to adhere tightly to each other, forming a primary hemostatic plug at the site of damage to the vessel, that is, urgently closing the resulting “hole”;

Third component These are blood plasma factors. There are fifteen of them in total, and most of them are enzymes in their biochemical structure. The task of plasma factors is to form a fibrin clot that will completely stop. Then the process of tissue regeneration will begin at this place, but that's another story.

Thus, hemostatic disorders may be due to a malfunction of any of the above components of the blood coagulation system, and in order to make sure that there are no problems or to establish their exact cause, doctors prescribe a coagulogram during pregnancy, before an upcoming surgical intervention, or in the presence of serious ones.

Types and indicators of coagulogram

The hemostasiogram includes a fairly large number of different blood parameters, not all of which are necessary in a particular diagnostic situation. Therefore, usually the doctor decides which coagulogram indicators need to be determined in the patient. There are several standard tests for different purposes: before a planned operation, during pregnancy, after a stroke or heart attack, following a course of treatment with drugs that affect blood clotting, for preventive purposes, and so on. Each of the typical coagulograms consists of a certain set of indicators, but if the diagnostic result deviates from the norm, the doctor will prescribe an extended analysis in order to assess the existing hemostasis disorders more objectively.

The study can be conditionally divided into three parts, according to the stages of blood coagulation in which specific parameters of the coagulogram are involved:

Stage 1- narrowing of damaged blood vessels, which in itself helps to reduce blood loss. Doctors and laboratory technicians call this process "the formation of prothrombinase";

Stage 2- platelet aggregation and the formation of a primary plug at the site of violation of the integrity of the vessel walls. Correctly referred to as "thrombin formation";

Stage 3- "plexus" of an elastic network of protein threads called fibrin. It covers the primary plug, clings to the edges of the hole and pulls it together, and then platelets line up tightly in the cells of the grid. It turns out a kind of patch, which finally stops the bleeding. In medicine, this period of blood clotting is denoted by the phrase "fibrin formation".

Now let's name the coagulogram indicators related to each of the three stages of hemostasis:

Formation of prothrombinase:

Contact activation index;

consumption of prothrombin;

Factor VIII activity;

Factor IX activity;

Factor X activity;

Factor XI activity;

Factor XII activity.

Thrombin formation:

International Normalized Ratio - INR;

Prothrombin in percent according to Quick or prothrombin index (PTI);

Factor II activity;

Factor V activity;

Factor VII activity.

fibrin formation:

thrombin time;

fibrinogen concentration;

Concentration of soluble fibrin-monomer complexes.

However, in deciphering the results of the coagulogram, other indicators may also appear that reflect the work of the blood function opposite in purpose - fibrinolytic, which plays an equally important role in the human body.

The anticoagulant blood system inhibits hemostasis in case of its redundancy and dissolves unnecessary blood clots so that they do not clog the lumen of the vessels. Thus, dynamic balance is formed and normal blood circulation in organs and tissues is maintained.

Let's give a specific example: a thrombus formed at the site of damage to the vessel, the process of regeneration went through, the wall overgrown, but the thrombus remained on the inside. Now it is not needed, because the integrity of the vessel is completely restored. Moreover, a blood clot is harmful because it blocks the lumen of the vessel and interferes with the free circulation of blood. It is then that the fibrinolytic system comes into play - its components dissolve an unnecessary thrombus and evacuate it from the bloodstream. In addition, someone must regulate the process of forming "patches", otherwise they may initially turn out to be so large that they cover the entire lumen of the damaged vessel. One of the components of the fibrinolytic system, antithrombin III, is designed to cope with this task.

In deciphering the results of an extended coagulogram, the following indicators of the anticoagulant function of the blood appear:

Lupus anticoagulant;

Protein C;

Protein S;

Antithrombin III.

Standard (screening) coagulogram

This blood test includes a set of critical blood clotting parameters:

Prothrombin in percent according to Quick (in international practice) or PTI prothrombin index (in the post-Soviet space);

fibrinogen;

Activated partial thromboplastin time (APTT);

Thrombin time (TV).

This includes the following metrics:

bleeding time;

Blood clotting time according to Lee-White;

Prothrombin in percent according to Quick or PTI;

consumption of prothrombin;

Plasma recalcification time (PRT);

thrombin time;

platelets;

Activated recalcification time (ART);

Activated partial thromboplastin time (APTT, APTT, ARTT);

International Normalized Ratio (INR);

fibrinogen;

Lupus anticoagulant;

Protein C;

Protein S;

Antithrombin III;

Factor II and V activity;

Factor VII activity;

Factor VIII, IX and IX activity;
factor XI;

factor XII.

This list may vary slightly in different laboratories, in addition, as we mentioned above, there are non-standard, specialized versions of the hemostasiogram, designed to solve typical diagnostic problems. Sometimes the doctor, right in the direction of the analysis, indicates those blood indicators that he needs to know in order to correctly assess the health status of a particular patient.

To whom and why is a coagulogram prescribed?

The study of hemostatic and fibrinolytic properties of blood is indicated in the following situations:

Preparation for elective or emergency surgery, including caesarean section;

Diseases of the heart and blood vessels - pulmonary embolism, thrombophlebitis and deep vein thrombosis;

Pathologies of the hematopoietic system - hemophilia, thrombocytopenia, anemia, von Willebrand-Dian disease, frequent nosebleeds, unexplained bruising, abnormally heavy menstruation and intermenstrual spotting;

Chronic liver diseases - fatty or alcoholic hepatosis, cirrhosis, hepatitis;

Pregnancy (for preventive purposes), severe toxicosis, preeclampsia, threatened miscarriage, miscarriage;

Suspicion of existing DIC;

Long-term use of hormonal birth control pills or blood thinners (Warfarin, Aspirin, Heparin, Trental and others);

Treatment with hirudotherapy sessions.

How much does a coagulogram cost, when can I expect the result?

You can take such an analysis at any private diagnostic center, and the cost will depend on the region and the pricing policy of a particular institution. In Moscow, a screening coagulogram will cost an average of 1,000 rubles, and an extended one will cost 3,500 rubles. Meanwhile, the study can be done free of charge, if there are indications: it is enough to consult a doctor at the place of residence, present a compulsory medical insurance policy and get a referral. A blood coagulogram is performed in any state laboratory at a clinic or hospital.

The term for obtaining the results of the analysis depends on the workload of the institution, but usually it is no more than two days. In emergency situations, a hemostasiogram is carried out immediately and the conclusion is passed to the attending physician.

Expectant mothers are entitled to a free blood coagulogram as part of pregnancy management and preparation for childbirth. In the absence of signs of pathology, the analysis is performed three times, that is, in each trimester.

In order for the results of the study to be accurate and reliable, it is necessary to adhere to the following rules for preliminary preparation:

Bring babies for analysis no earlier than 1 hour after feeding;

Babies aged 1 to 5 years should be brought 2-3 hours after eating;

Children over 5 years of age and adults should abstain from food for 12 hours;

30 minutes before donating blood for a coagulogram, sit down and calm down;

Immediately before the analysis, do not smoke, stop drinking alcoholic beverages 24 hours in advance;

Warn the laboratory assistant about all medications taken the day before.

Blood for this study is taken from a vein in the elbow. It is very important that the arm in this place does not have any damage, otherwise platelets, fibrin or clotting factors may enter the sample, and this will distort the results of the coagulogram. For reliability, blood is collected in two test tubes, only the second of which is used for testing.

Coagulogram norms in adults and children

The table below shows the normal parameters of an extended hemostasiogram in adults and children. It should be noted that these figures vary slightly depending on age. Significant differences in the work of the hemostatic and fibrinolytic blood systems are inherent only in premature babies and healthy infants in the first two months of life.

Parameter and unit	Norm for adults	Norm for children
Bleeding time, min.
Coagulation time according to Lee-White, min.
Prothrombin time, sec.
Prothrombin according to Quick,%
Consumption of prothrombin,%

Time of plasma recalcification GRP, sec.
Thrombin time, sec.
Platelets, g/l
Activated AVR recalcification time, sec.
APTT (APTT, ARTT), sec.

	3.36-4.0 mg/100 ml
fibrinogen		5.9-11.7 µmol/l
Lupus anticoagulant	missing	missing
D-dimers, ng/ml
Protein C,%
Protein S, units/ml
Antithrombin III,%
Factor II and V activity,%
Factor VII activity,%
Factor VIII, IX and IX activity, %
Factor X,%
Factor XI,%
Factor XII,%

Now let's look at what the most important indicators from this table mean, and what the deviation of the analysis results from the norm up or down indicates.

Bleeding time

To establish this indicator, the doctor conducts a simple test - pierces the patient's earlobe and detects how many minutes the bleeding will stop. The sooner this happens, the better, but the lengthening of time may indicate hemophilia, thrombocytopenia, hemorrhagic fever, or an overdose of anticoagulants.

Lee-White clotting time

This is the time during which a blood clot forms at the site of damage to the vessel. If this happens too quickly, then there is a risk of thrombosis, and if it happens too slowly, then the patient has a tendency to bleed - he may lose a lot of blood as a result of an injury or during a surgical operation. There are a number of pathologies that are characterized by prolongation of blood clotting time: hemophilia, DIC in the later stages, burn disease, malignant tumors, severe inflammatory lesions of internal organs, systemic autoimmune diseases, phosphorus poisoning. A shortening of the Lee-White clotting time is observed in myxedema, anaphylactic and hemorrhagic shock, DIC at the initial stages of development.

Activated Recalcification Time (ART)

This is the period during which a network of fibrin fibers is formed in the plasma saturated with calcium and platelets. There is also an indicator of GRP - the time of plasma recalcification, it also characterizes the overall activity of the coagulation system, the differences are only in the method of conducting the test. The deviation of both of these parameters from the norm to a greater extent indicates hemophilia, thrombocytopathies, long-term use of anticoagulants, post-traumatic shock, and to a lesser extent - the risk of thrombosis.

Activated partial thromboplastin time (APTT, APTT, ARTT)

This is perhaps the most informative diagnostic parameter of the coagulogram. It reflects the effectiveness of hemostasis and characterizes the period during which a fibrin patch is formed at the site of tissue damage. Prolongation of APTT is observed in congenital and acquired deficiency of blood coagulation factors, autoimmune diseases, severe liver pathologies, DIC, overdose of anticoagulants, hemophilia, von Willebrand's disease, beriberi, chronic glomerulonephritis, condition after blood transfusion. A shortened APTT may indicate the onset of DIC, a tendency to thrombosis, acute blood loss, metastasis of a malignant neoplasm, or simply that the blood for analysis was taken incorrectly.

Activity of all blood coagulation factors (II, V, VII, VIII, IX, X, XI, XII)

These parameters never change without serious reasons: an increase or decrease in the activity of coagulation factors clearly indicates a disease characterized by either excessive thrombus formation or bleeding. When deciphering the results of a coagulogram, data on the activity of coagulation factors should be considered together with other indicators.

Prothrombin time (PT)

This is the period during which a thrombin clot forms in the plasma with calcium and thromboplastin. In premature babies, after birth, a longer prothrombin time is recorded than in full-term babies - 14-19 seconds versus 13-17. And in adults, this parameter varies within 11-15 seconds. The measurement of prothrombin time makes it possible to evaluate the work of the so-called inner circle of hemostasis, which is responsible for stopping bleeding in organs and tissues, and not on the surface of the body. Elongation of PV is observed with a deficiency of coagulation factors or fibrinogen, biliary stenosis, liver pathologies, hemorrhagic diathesis, celiac disease. Shortening of PT is characteristic of low hematocrit, elevated levels of antithrombin III, activation of fibrinolysis, thromboembolism and thrombosis.

Quick prothrombin, prothrombin index (PTI) and INR

This is the ratio of the patient's prothrombin time to the ideal value of this parameter, which is expressed as a number or as a percentage. Currently, these indicators are considered obsolete, since in 1983 the World Health Organization introduced a new term - INR - an international normalized ratio, which means, in fact, the same thing. The deviation of PTI and INR from the norm up or down when deciphering the results of the coagulogram is explained by the same reasons as the lengthening and shortening of the prothrombin time, since these parameters are directly related.

Thrombin Time (TV)

This indicator characterizes the final stage of hemostasis and is calculated by adding thrombin to the plasma. If the fibrin network is formed for too long, this indicates acute fibrinolysis and fibrinogen deficiency, DIC, autoimmune disease, severe liver disease, multiple myeloma, uremia, long-term therapy with streptokinase or urokinase. If the "patch" of fibrin is formed too quickly, this indicates the beginning of the development of DIC, the use of heparin or inhibitors of fibrin polymerization.

fibrinogen

It is a protein that is produced by the liver. When bleeding begins, fibrinogen is converted to fibrin by the action of the Hageman factor, and from it, in turn, a “patch” is formed. Therefore, fibrinogen is classified as an acute phase protein - an increase in its concentration in the blood indicates injury, burns, myocardial infarction, growth, inflammation of internal organs, autoimmune pathology. And a decrease in the level of fibrinogen in the blood indicates its congenital deficiency, DIC, liver disease, leukemia, homonucleosis, food poisoning, taking heparin, androgenic hormones, anabolics, barbiturates, valproic acid.

Soluble fibrin-monomeric complexes (SFMK)

These substances are products of fibrin breakdown and are registered in the blood during fibrinolysis. Accordingly, RFMK is of primary importance for the early diagnosis of DIC. If, when deciphering the results of a coagulogram in the blood, an increase in the level of RFMK is detected, this may also indicate thrombosis, thromboembolism, autoimmune pathology of connective tissues, shock, postoperative complications, preeclampsia, preeclampsia in pregnant women.

Antithrombin III

It is from this protein that three-quarters depends on the effectiveness of the entire fibrinolytic system, which is necessary to control blood clotting and dissolve unnecessary blood clots. The level of antithrombin of the third type increases with, and other inflammatory diseases, as well as after kidney transplantation and long-term use of anabolic steroids. The lack of antithrombin III is characteristic of liver failure, cirrhosis of the liver and the period after its transplantation, DIC, thrombosis, pulmonary embolism, myocardial infarction, and the use of oral contraceptives.

Lupus anticoagulant

This is a protein that indicates the presence of antiphospholipid syndrome or antiphospholipid antibody syndrome (APA). It leads to the formation of multiple blood clots and pathologies during pregnancy. Deciphering the results of a coagulogram of a healthy person should not contain data on the presence of lupus anticoagulant.

D-dimers

These substances are constantly present in the blood, but especially a lot of them appear as a result of the breakdown of a large amount of fibrin. And this process indicates too active blood clotting and dissolution of unclaimed blood clots. Accordingly, an excess of D-dimers in the coagulogram indicates the onset of the development of DIC, blood poisoning, acute heart attack, thromboembolism, kidney or liver failure, postoperative complications, growth of a malignant neoplasm, large hematoma, preeclampsia.

Protein C

This protein is needed to control the process of hemostasis and prevent the formation of too large clots inside damaged vessels. When deciphering the results of the coagulogram, the doctor has concerns if the level of protein C in the blood is too low. This may indicate the development of DIC, liver disease, or simply a congenital deficiency of the corresponding protein.

Protein S

And this is an activator of protein C and antithrombin III - without it, the anticoagulant function of the blood would be impossible. The lack of protein S can also be hereditary, and may develop against the background of long-term use of drugs that thin the blood (Heparin, Warfarin, Aspirin).

During the period of bearing a child, the total volume of circulating blood in a woman increases by an average of 25%. This is necessary in order to simultaneously serve the organisms of the expectant mother and fetus. In addition, you need to insure against extensive blood loss in case of miscarriage, premature detachment of the placenta, as well as before the decisive natural event - childbirth. Consequently, the activity of the blood coagulation and anticoagulation systems also increases during pregnancy: in the second trimester - by 15-20%, in the third - sometimes by 30% compared to a healthy woman who is not expecting a baby.

It is very important to donate blood for a coagulogram during pregnancy three times. Deviations from the norm in time will indicate to the doctor the risk of spontaneous abortion, uterine bleeding, fetoplacental insufficiency, preeclampsia, DIC, preeclampsia and eclampsia, as well as extensive blood loss during childbirth or during cesarean section.

Of course, expectant mothers are worried about this and want to know the decoding of the results of the coagulogram during pregnancy. To begin with, we bring to your attention a table of norms for trimesters, and then we will tell you what deviations in indicators mean.

Indicator, unit	Itrimester	IItrimester	IIItrimester
Thrombin time, sec.
Prothrombin,%
APTT, sec.
D-dimers, mg/l	no more than 1.1	no more than 2.1	no more than 2.81

Platelets, *109/l
Prothrombin index,%

Antithrombin III, g/l
Fibrinogen, g/l

Deciphering the results of a coagulogram during pregnancy

Normally, the first trimester is characterized by some inhibition of both coagulation and anticoagulation functions of the blood, and then, as we approach childbirth, the indicators increase. The table below shows the likely causes of deviations from the norm.

Index	decline	Raise
	Stage 1 DIC, thrombosis	Stage 2-3 DIC
Prothrombin time and INR	Stage 1 DIC, approaching labor	Stage 2-3 DIC
Prothrombin	less than 70% - stage 1 DIC	risk of placental abruption
thrombin time	less than 10 seconds - stage 1 DIC	more than 26 seconds - stage 2-3 DIC
Antithrombin III	less than 50% of the norm - fetoplacental insufficiency, the threat of placental abruption	threatened miscarriage, uterine bleeding, hepatitis
		preeclampsia, diabetes mellitus, kidney failure
fibrinogen	less than 3 g / l - severe toxicosis, preeclampsia, stage 2-3 DIC, beriberi	Stage 1 DIC, acute infection, heart attack, stroke, malignancy
Lupus anticoagulant	the appearance indicates preeclampsia, preeclampsia, the threat of miscarriage, placental abruption, premature birth
	almost never occurs and does not matter	an increase of more than 4 times - stage 1 DIC, the threat of placental abruption

If several indicators deviate from the norm in deciphering the coagulogram during pregnancy, this does not mean that the expectant mother and baby are in serious danger. Only if almost all parameters of the study are abnormal should the alarm be sounded.

In conclusion, I would like to emphasize that only a qualified gynecologist can draw the right conclusions by looking at the results of a hemostasiogram of a pregnant woman. Each organism is individual, and during the bearing of a child, everyone adapts to changing conditions in different ways. Do not jump to conclusions and panic ahead of time - this in itself is very harmful in such a period. Take care of yourself and be healthy!

Education: In 2013, he graduated from the Kursk State Medical University and received a diploma in General Medicine. After 2 years, the residency in the specialty "Oncology" was completed. In 2016, she completed postgraduate studies at the Pirogov National Medical and Surgical Center.

In the article, we will consider how to pass a coagulogram.

This is a special laboratory study in which the features of blood coagulation are determined. This analysis plays an important role in the study of the patient's condition.

It is important to know how to take an analysis for a coagulogram. Its values help to suggest how successful the delivery or surgery will be, whether the patient will survive, whether it will be possible to stop bleeding in a critical situation. However, not all specialists have the skills to read a coagulogram. But it is precisely such research that often becomes a factor in saving human life.

So, let's figure out what a coagulogram is, and why they rent it.

Blood is a biological fluid that has the ability to circulate through the vessels and form clots (blood clots). This quality allows it to close the gap in small and medium-sized veins and arteries, and sometimes this process goes unnoticed by a person. Blood clotting and keeping it in a liquid state is regulated by a body system called hemostasis.

This biological system consists of three main components:

Vascular cells, namely the inner layer of blood vessels (endothelium) - when the vessel wall is ruptured or damaged, endothelial cells secrete a number of active substances (prostacyclin, nitric oxide, thrombomodulin), which trigger the processes of thrombosis.
Platelets are special platelets that rush to the site of injury first, after which they stick together and close the wound, forming a hemostatic plug. If these platelets fail to stop the bleeding, the plasma properties of blood clotting come into play.
Plasma factors - the process of hemostasis includes 15 such factors (many of them are enzymes), which, as a result of a series of chemical reactions, form a fibrin clot of a dense structure, which finally stops bleeding. A feature of these factors of the coagulation system is that almost all of them are produced in the liver with the help of vitamin K.

The processes of human hemostasis are also controlled by fibrinolytic and anticoagulant systems. Their main function is to prevent spontaneous thrombosis.

How to pass a coagulogram, it is important to find out in advance.

Indications for appointment

The list of main indications for the appointment of a hemostasiogram includes the following:

general assessment of the hemostasis system;
caesarean section or independent childbirth;
planned studies before operations;
gestoses occurring in severe forms;
control of exposure treatment (Warfarin, Aspirin, Trental), heparin medications (Fraxiparin, Clexane);
diagnosis of various hemorrhagic diseases (Villebrant's disease, hemophilia, thrombocytopathy and thrombocytopenia);
varicose veins of the lower extremities;
with a high probability of thrombosis (with atrial fibrillation, coronary heart disease);
definition of DIC;
the use of oral contraceptives, anabolics, glucocorticosteroids;
liver disease in chronic forms (cirrhosis);
inflammatory processes of an acute nature in the body;
in the diagnosis of various thrombosis - intestinal vessels, lower extremities, pulmonary embolism, ischemic stroke.

How to take a coagulogram correctly, the doctor will tell.

Preparation for the study

Preparation for this study is of great importance.

Many are interested in how to take a coagulogram - on an empty stomach or not.

Biological material is taken on an empty stomach. In this case, it is necessary that the meal was at least 12 hours ago. Before taking the test, it is not recommended to consume spicy, smoked, fatty foods, alcoholic beverages, it is strictly forbidden to smoke.

Everyone should know how to donate blood for a coagulogram correctly.

Another important condition is the cessation of taking indirect and direct anticoagulants, since their presence in the blood can significantly distort laboratory tests. In cases where taking such medications is a vital condition for the patient, it is necessary to warn the specialist who will conduct the study about this. So, how to pass a coagulogram?

How is a blood coagulation test performed?

The sampling of biomaterial is carried out with a sterile dry syringe or a special Vacutainer vacuum blood collection system. This event should be carried out with a needle with a wide lumen without the use of a tourniquet.

The puncture of the vein must be atraumatic, otherwise a large amount of tissue thromboplastin will enter the test tube for research, which also significantly distorts the results of the analysis. The laboratory assistant fills 2 test tubes with blood, while only the second one is sent for analysis. The test tube must contain sodium citrate (special coagulant).

Is it possible to take a coagulogram during menstruation? This is a common question. We will talk about this at the end of the article.

How many days do a coagulogram?

To obtain the correct results of the study, the laboratory assistant conducts certain chemical reactions, which require some time. This process usually takes 1-2 days. However, much depends on the workload of the laboratory, the work of employees, the availability of reagents.

It is not in vain that we tell you how to take a coagulogram correctly. This affects the accuracy of the results.

Norms of the coagulogram

Normally, hemostasis indicators are as follows:

the blood clotting interval is 5-12 minutes;
bleeding period - from 2 to 8 minutes;
prothrombin time - 11-15 sec;
22.6-35.8 sec;
activated recalcification period ABP 82-126 seconds;
prothrombin index - 72-123%;
thrombin time - 14-21 seconds;
fibrin-monomeric complexes - 0.356-0.478 units;
antithrombin III - 75.9-124.6%;
D-dimer - 250.09-500.48 ng/ml;
fibrinogen 2.6-4.023 g.

Why take a coagulogram, what indicators does it reveal?

Decryption

In order to correctly understand the significance of this analysis, it is necessary to familiarize yourself in more detail with each of its indicators, since they reflect the most important properties of the blood of a particular patient. When decoding, normative values for a certain age are taken into account.

ON

Prothrombin time is the period of formation of a blood clot if thromboplastin and calcium are added to the plasma. This indicator reflects two phases of plasma coagulation and the functionality of 10, 7, 5 and 2 factors. The norms of prothrombin time at different ages are:

premature babies - 13-18 seconds;
full-term babies - 12-16 sec;
young children - 14-17 sec;
older children - 12-16 seconds;
in adults - 11-16 sec.

Treatment with anticoagulants is considered effective if this indicator rises at least 2 times.

INR

INR (prothrombin ratio) is the ratio of the patient's PV to the PT of the control tube. The main goal of the INR assessment is to control the intake of indirect anticoagulants. The reasons for the change in INR indicators are:

prolongation of prothrombin time;
liver diseases (hepatitis, cirrhosis of the liver);
lack of vitamin K in enteropathy, dysbacteriosis;
nephrotic syndrome;
amyloidosis;
DIC; hereditary deficiency of coagulation factors (10, 7, 5, 2);
absence or decrease in the concentration of fibrinogen;
therapy with coumarin derivatives ("Merevan", "Warfarin");
treatment with anticoagulant medications;
thromboembolism and vascular thrombosis;
increase in the activity of factor 7;
activation of fibrinolysis.

It is interesting for many women to take a coagulogram on which day of the cycle.

APTT

This indicator indicates the partial activated thrombin time, the effectiveness of plasma factors in stopping bleeding. APTT reflects the path of hemostasis, and how quickly a fibrin clot is formed. This is the most accurate and sensitive indicator of the hemostasiogram. APTT depends on the reagents-activators used by specialists. A shortened APTT indicates a high coagulability, the likelihood of thrombus formation, and an elongation indicates a decrease in the level of hemostasis. Reasons for changing this value:

acquired or congenital factor deficiency (12,10,9,8,5,2);
fibrinolysis;
DIC;
therapy with heparin and its analogues ("Cibor", "Clexane", "Fraksiparin");
autoimmune diseases (lupus erythematosus);
pathology of the liver of severe forms (fatty infiltration, cirrhosis);
high blood clotting;
improper blood sampling (tissue thromboplastin contamination).

AVR

Activated recalcification time - the period required for the formation of fibrin in blood saturated with platelets and calcium. This value reflects how effectively the cellular and plasma parts of hemostasis interact. The indicator may depend on the reagents. AVR lengthens with a decrease in the number of platelets (thrombocytopenia) and a violation of their quality (thrombocytopathy), as well as with hemophilia. AVR is shortened in the presence of a tendency to thrombosis.

PTI

The prothrombin index is the ratio of the normal prothrombin time to that observed in the patient, and is multiplied by 100%. This indicator increases with:

deficiency of hemostasis factors;
vitamin K deficiency (enterocolitis, colitis);
therapy with indirect anticoagulants ("Neocoumarin", "Warfarin", "Sinkumar");
treatment with drugs "Heparin", "Clexane", "Flenox";
liver damage;
vascular thrombosis;
increased clotting during pregnancy or childbirth.

TV

Thrombin time reflects the final stage of hemostasis. It characterizes the time period required for the formation of a fibrin clot if thrombin is added to the plasma. This indicator is determined together with PT and APTT to control heparin therapy and fibrinolytic diagnosis of congenital fibrinogen pathologies. Factors that prolong thrombin time are:

acute fibrinolysis;
treatment with fibrinolytic drugs ("Urokinase", "Streptokinase");
DIC;
autoimmune diseases (presence of antibodies to thrombin);
liver disease;
therapy with fibrin inhibitors and heparin.

fibrinogen

This is one of the blood. This protein is formed in the liver and under the influence of the Hageman factor and is converted into insoluble fibrin. Fibrinogen is classified as an acute phase protein; its plasma level increases with stress, infection, and trauma. This indicator may change in the following cases:

inflammatory pathologies of a severe course (peritonitis, pyelonephritis, pneumonia);
systemic connective tissue pathologies (SLE, rheumatoid arthritis, scleroderma);
myocardial infarction;
oncological tumors;
pregnancy;
burn disease;
amyloidosis;
after surgical interventions;
period of menstruation;
therapy with heparin and its analogues, as well as estrogens (use of hormonal contraceptives);
DIC;
leukemia, aplastic lesions of the bone marrow;
liver pathology;
oncology of the prostate with metastases;
conditions after bleeding;
treatment with androgens, anabolics, barbiturates, valproic acid, fish oil, fibrin polymerization inhibitors;
heparin poisoning

RFMK

This indicator - which are intermediate products of the breakdown of a fibrin clot as a result of fibrinolysis. They are very quickly removed from the plasma, the indicator is extremely difficult to determine. RFMC increases with:

thrombosis of various localization;
in the postoperative period;
complications of pregnancy (preeclampsia, preeclampsia);
renal failure;
shocks;
sepsis;
systemic connective tissue pathologies.

Antithrombin III

It is a physiological anticoagulant substance. Structurally, it is a glycoprotein that inhibits thrombin and some coagulation factors. The main site of its production is the liver cells. A change in the level of a given substance occurs when:

severe inflammatory diseases (pyelonephritis, peritonitis, pneumonia);
acute liver damage (hepatitis);
lack of vitamin K;
anabolic therapy, glucocorticosteroids;
hereditary and congenital deficiency;
liver pathologies (cirrhosis, alcoholic disease);
DIC;
late pregnancy;
thrombosis and thromboembolism;
sepsis;
treatment with heparin and inhibitors of fibrin polymerization.

D-dimer

This value characterizes the remains of split fibrin strands and the work of hemostasis. If the D-dimer is elevated, it means that too much fibrin has been broken down. It is contained in the blood for about 7 hours after its formation, so the biomaterial must be examined immediately. Diagnostic value has an increase in this indicator, which is observed when:

thrombosis and thromboembolism;
liver diseases;
ischemic heart disease and heart attack;
extensive hematomas;
in the postoperative period;
prolonged smoking;
rheumatoid seropositive arthritis;
DIC syndrome.

Bleeding time

The clotting time indicates the interval required for the formation of a blood clot. In practice, only an increase in this indicator is estimated, since this indicates:

lack of platelets;
hemophilia;
liver damage from alcohol;
hemorrhagic fever;
thrombocytopathy and thrombocytopenia;
overdose of anticoagulants and anticoagulants.

Is it possible to take a coagulogram during menstruation?

Analysis during menstruation

This laboratory test during menstruation, as a rule, cannot give a clear result. This is due to the fact that during this period the blood is the most liquefied, and it is not possible to check its coagulation properties.

That is why it is so important to find out how to pass a coagulogram. Especially when it comes to women.

Therefore, for the implementation of this procedure, it is best to wait until the end of menstruation, however, do not analyze immediately after it. The body in this period is interested in removing blood from the uterus, so clotting is somehow impaired. After the end of critical days, all processes of a similar nature return to normal, and the patient may well go for tests.

There were cases when women passed a coagulogram during menstruation. Their results were inaccurate.

Before the start of menstruation, it is also not recommended to carry out such a procedure, since the body is preparing to withdraw blood, which is already gradually thinning during this period. The analysis will be incorrect and will have to be repeated.

On what day of the cycle to take a coagulogram?

The most optimal time for conducting this laboratory analysis in women is 5 days before the onset of menstruation and the same after its completion, that is, 10-20 days of the cycle. In this period of time, the result will be the most reliable.

We examined what a coagulogram is and why it is taken.

A coagulogram (hemostasiogram) is one of the most important tests in a laboratory blood test. It is necessary for a detailed study of the ability of blood to coagulate.

It is prescribed, as a rule, when carrying a child, in case of a patient's predisposition to the formation of blood clots, and also before a serious surgical intervention. Each person should have an idea of what kind of analysis it is, how it is carried out, and what it can show.

Description

A hemostasiogram is a laboratory study of blood fluid that allows you to evaluate hemostasis - a complex biosystem that is necessary to maintain the fluid properties of blood, dissolve formed blood clots in a timely manner, and help stop bleeding.

To maintain basic functions, blood must meet the following requirements:

have a sufficiently liquid consistency, which allows you to provide vital organs and tissues with oxygen and the necessary nutrients through their movement through the blood vessels, control the functioning of the protective properties of the body, and promote the elimination of toxic substances;
maintain a certain degree of viscosity to close the gaps in the vessels in case of injury.

If there is a decrease in coagulability to a critical level, then with intense bleeding, the body dies.

Increased blood viscosity and clotting (hypercoagulability) provoke the formation of its clots, which can provoke the development of a stroke, thromboembolism or heart attack as a result of the overlap of important vascular systems.

Conducting a coagulogram is necessary, since control of hemostasis helps prevent the formation of blood clots, blood loss and clogging of blood vessels.

This study is one of the most difficult, since a specialist must have all the necessary knowledge to assess the state of not only each specific indicator, but also all of them.

Research types

The hemostasiogram is classified into two types:

basic;
expanded (extended coagulogram).

The first type allows you to identify only existing violations in hemostasis.

In the second, a complete study is carried out, which makes it possible to establish the cause of the pathological process and differentiate the disease from other disorders that have a similar effect.

In addition, an important component is the conduct of a qualitative and quantitative analysis of violations.

Why carry out

The analysis includes the evaluation of many indicators. Everything will depend on the goal. For each person, specific parameters are indicated.

In most situations, a coagulogram involves the study of the following values:

Prothrombin. This is a complex protein, the amount of which indicates the general state of hemostasis. An increase in normal values indicates a predisposition to the formation of thrombosis, and a decrease indicates bleeding.
Norm of the prothrombized index. Assess how long the patient's blood coagulates.
Activated partial thromboplastin time is the time it takes for a blood clot to form.
INR - the ratio of prothrombized time to its average value. If the indicator is too high, then the patient is predisposed to bleeding, if it is underestimated, to thrombosis.
fibrinogen. It is considered one of the main proteins in the formation of a blood clot during the clotting period. Its increase will indicate the development of inflammation. In addition, there may be disturbances in the work of the heart and vascular system. If the protein is present in a reduced amount, then we can talk about liver disease or a predisposition to bleeding.
Antithrombin 3. Helps reduce coagulability.
Thrombosed time - the duration of the final stage of coagulation.
Platelet concentration.
D-dimer. Necessary to control the thrombus formation process. With its rapid increase, the risk of having diseases of the blood, kidneys or diabetes mellitus increases.
. In a normal state, it should not be. The presence of this parameter indicates autoimmune disorders in the human body.

During the study, all 3 stages of blood clotting should be checked.

When appointed

According to the advice of most experts, it is necessary to do a coagulogram before the operation, regardless of its complexity. In addition, the analysis is necessary during pregnancy.

Also among the indicators for biochemical analysis are:

severe preeclampsia in pregnant women;
preparation for surgery;
varicose veins;
high tendency to thrombosis;
the use of a certain number of medications that can affect blood clotting;
cirrhosis of the liver;
acute inflammation;
diseases of the cardiovascular system (ischemia, atrial fibrillation).

Often, a hemostasiogram is prescribed to assess the general state of hemostasis, as well as to monitor the patient's condition during therapeutic measures that involve treatment with anticoagulants.

Also, the study is done with serious prolonged bleeding or hematomas on the body, which can form even in the absence of mechanical damage.

Normal performance

Normally, the values of the parameters in adults are equal to those given in the table below.

Clotting time
Prothrombin index
thrombin time	11-17.8 seconds
fibrinogen concentration
fibrinogen	5.9-11.7 µmol/l
Fibrinogen B	negative
fibrinolytic activity	183-263 minutes
Activated Recalcification Time (ART)	50-70 seconds
Activated partial thromboplastin time (APTT)	24-35 seconds
Thrombotest	IV-V degree
Plasma tolerance to heparin
Duke bleeding time
Retraction of a blood clot
Soluble fibrin-monomeric complexes ()	up to 4 mg/100ml
Plasma recalcification time (PRT)	60-120 seconds

In children, as a rule, the data are somewhat different. During the neonatal period, fibrinogen should be in the range of 1.25-3.00 g / l.

Norms in childhood:

In pregnant women, the indicators will be as follows:

Index	1 trimester	2 trimester	3rd trimester
platelets
fibrinogen



Antithrombin III

How to donate blood for analysis

To get the most reliable results, you need to properly prepare for the study.

Training

Before screening, the patient must follow all the recommendations that the specialist will give him:

Refuse to eat 12 hours before the session. If you can not avoid dinner the day before, then preference should be given to light meals.
Stop taking all medications that involve minor breaks.
Eliminate any drinks from the diet, especially alcohol. You are allowed to drink clean water.
Reduce physical activity.
Do not stress the body.
Do not smoke at least one hour before the procedure.

If you do not follow these rules, then the likelihood of obtaining false data increases.

Holding

Donate blood for analysis exclusively on an empty stomach. You can take it from a finger or a vein.

After all devices and the place where the biomaterial is taken from are disinfected, the laboratory assistant makes a puncture in the area of the skin with minimal trauma, which must also be observed in order to exclude data distortion as a result of penetration of thromboplastin tissues.

To exclude this possibility, it is necessary to fill two test tubes with the material. The latter is sent for research. If blood is taken from a vein, then the tourniquet is not used.

In addition, a special substance, a coagulant, must be added to the test tube.

The procedure itself is painless. Unpleasant sensations occur only at the time of puncture of the skin. After a coagulogram, there may be slight weakness in the arm.

Data interpretation

The interpretation of the results is carried out exclusively by a specialist. This takes into account all the indicators that were described above.

When making a final diagnosis, it is also necessary to take into account the medical history, the results of the examination of the patient, and a general blood test.

Generally speaking, an excess of the parameters of normal values will indicate a thickening of the blood fluid, and a decrease will indicate a deficiency of platelets in the blood.

How many days is the study

The period required for the study will depend on many predisposing factors.

In most cases, a coagulogram is done for a maximum of 1-2 days. Sometimes it can take up to ten days. Everything will depend on the serviceability of the equipment, the workload of the laboratory and the worker. With an additional payment for urgency, the results of the analysis are issued on the day of its delivery.

Coagulogram for children

The procedure is prescribed for a child in the following cases:

the planned surgical intervention;
frequent bleeding is diagnosed, and there are also wounds that heal for a long time.

In addition, a blood test is necessary if there is a suspicion of the development of pathological processes that adversely affect blood clotting.

When done to women in position

During pregnancy, the body is restructured for the upcoming motherhood. Changes do not bypass the hemostasis system, which is caused by a violation of the hormonal background and the formation of an additional circle of blood circulation.

During this period, the parameters of the coagulogram will indicate an increased activity of factors that are responsible for blood clotting, as well as an increase in fibrinogen.

Parts of fibrin begin to be deposited on the vascular walls of the uteroplacental circle. Against this background, the process of fibrinolysis is suppressed, preventing thrombosis and placental abruption.

These changes allow you to protect the body of the expectant mother from a natural termination of pregnancy and the development of bleeding in the uterus.

If the period of bearing a child is complicated by pathologies and the manifestation of preeclampsia, blood clotting is disturbed.

In the absence of timely treatment, DIC may develop, which is characterized by the formation of a large number of small blood clots and impaired blood flow to the fetus. In more severe cases, uterine bleeding is not excluded, which is dangerous not only for the fetus, but also for the life of a woman.

To prevent such conditions, it is recommended to do a hemocoagulogram every trimester.

Cost of the procedure

The price will depend on the equipment used and the amount of work carried out. For example, a basic study will cost 700-1500 rubles. The cost of the extended one will vary within 3500 rubles.

During pregnancy, if you have a compulsory health insurance policy, the procedure is carried out free of charge, since the examination in this case is mandatory.

A coagulogram is one of the most important laboratory techniques that allows you to determine all the parameters of blood coagulation.

The procedure is prescribed before surgery, with cardiac pathologies or during pregnancy. The results obtained allow us to assess the risks of blood clots or bleeding.

The normal coagulation parameters in the table include optimal indicators. So, when conducting an analysis, a person receives several numbers as a result. These include APTT, Fibrinogen, Lupus Coagulant, Platelets, Prothrombin, TB, D-Dimer, and Antithrombin III.

If we are talking about an extended analysis, then the following are attributed to these indicators: Prothrombin time, Protein S, Protein C and Willebrand factor.

All these "elements" must have certain numbers. They indicate that everything is normal, or has a slight deviation. In normal form, the indicators should be as follows:

With any deviation, the norm of the coagulogram is not similar to the given data. This phenomenon requires finding out the cause and eliminating the problem itself.

Coagulogram indicators are normal if there are no negative processes in the human body. Moreover, if the patient does not take indirect coagulants, then changing the main "elements" is simply impossible.

If there are deviations, then it is necessary to find out the reason without fail. The fact is that a decrease in some indicators can lead to thrombosis, which is especially dangerous for humans. If we are talking about a pregnant girl, then any deviations can provoke not only the formation of blood clots, but also premature detachment of the placenta. Therefore, the norm of the coagulogram should always be viewed, this will avoid serious complications.

INR coagulogram norm

The norm of the coagulogram depends on many indicators. So, this "element" is a calculated data, thanks to which you can find out the ratio of the patient's prothrombin time to the average prothrombin time. This indicator is necessary for therapy with indirect coagulants.

The fact is that these medicines can worsen blood clotting and lead to serious problems. Patients who are on such therapy should monitor the INR.

Normally, this "element" is less than 1.25. If the figure is underestimated or overestimated, it is necessary to look for the cause of this phenomenon. Basically, a sharp decrease in INR indicates an insufficient effect that anticoagulants give, which requires some intervention. This process can lead to a significant risk of thrombosis. The norm of the coagulogram of the INR indicator should not fluctuate, because otherwise it is harmful to the body and most likely the negative process has already begun.

Fibrinogen norm

The norm of the coagulogram fibrinogen, if violated, can lead to increased bleeding. Under this indicator, a specific protein is hidden. It refers to the main component of a blood clot, which is able to form during blood clotting. Fibrinogen, by virtue of its qualities, is responsible for many functions regarding the coagulation process.

This indicator fluctuates most strongly during pregnancy, and there is nothing to worry about. But still, a woman should be under the supervision of a doctor. Indeed, in some cases, this may indicate the presence of an inflammatory process or the risk of developing cardiovascular complications. All this can occur against the background of increased blood clotting, which is not the norm. In general, this indicator should not exceed 6.5 g / l.

With a significant decrease in it, severe bleeding may develop, which can be congenital. It is worth watching the “element” during pregnancy, and paying special attention to this moment. After all, the norm of the coagulogram of this indicator must be observed.

PTI coagulogram norm

The norm of the coagulogram pti is the ratio of the clotting time of normal plasma to the clotting time of the patient's plasma. This number should be expressed as a percentage and not exceed 78-142%.

This indicator can increase, but only at the risk of developing blood clots. The set number decreases with a tendency to bleed. That is why it needs special attention.

It should be noted that in pregnant women this indicator can vary slightly and this is the norm. True, this may be due to premature detachment of the placenta.

An increase in the index indicates the presence of increased blood clotting. This is not entirely good, because it can lead to the development of cardiovascular diseases. In some cases, the indicator varies due to long-term use of oral contraceptives. In any case, the true cause of such a phenomenon must be determined. The norm of the coagulogram of the prothrombin index must be observed.

RFMK coagulogram norm

The norm of the coagulogram rfmk depends on many things. Basically, this indicator is necessary in order to determine the amount of soluble complexes in the blood.

These "elements" are markers of thrombinemia in intravascular coagulation. This indicator can only be determined manually. Naturally, the procedure is not complicated and is carried out quite quickly. Ideally, there should not be any complexes in the human blood at all.

RFMK is not at all mandatory. Rather, it is done before a serious surgical intervention. This indicator is taken from the blood that was submitted for analysis. The higher the concentration of complexes in it, the higher the risk of intravascular thrombosis. Therefore, RFMC plays a significant role.

Its decrease indicates treatment with heparin. This is quite effective when it is necessary to prescribe heparin prophylaxis or heparin therapy. RFMC norm of coagulogram should not go beyond 0-0.4.

Norm of coagulogram D dimer

The norm of the coagulogram d dimer plays a significant role. So, this indicator is a fibrin breakdown product. It shows violations of the blood coagulation process. This element is especially important in the diagnosis of thrombosis, pregnancy and cancer.

The dimer has always been considered a specific degradation product that is part of the thrombus. According to these data, it is possible to monitor the intensity of the processes of formation and destruction of fibrin clots.

Many factors can affect this figure. Determination of the Dimer level is considered specific. Its level depends on the presence of pathological conditions that can be accompanied by enhanced fibrinolysis. These include various kinds of infections, wound healing, hemorrhagic complications, and similar processes. Normally, Dimer does not exceed 33-726 ng/ml. If there are any violations, then they must be neutralized without fail. Because the norm of the coagulogram of this indicator must be fully observed.

The norm of the coagulogram PV

The norm of the PV coagulogram is another important indicator. Prothrombin time is an "element" that reflects the rate of blood clotting. It is used to diagnose diseases of the blood coagulation system. In addition, it allows you to evaluate the effect of drugs that are aimed at worsening the ability to coagulate.

Normally, this indicative should not exceed 10-13 seconds. Any deviations indicate the presence of pathological processes in the body. An indicator above the norm indicates that there is a low concentration of clotting factors, a lack of vitamin K, as well as liver disease or a violation of its functions.

It is likely that we are talking about the presence of disseminated intravascular coagulation syndrome. This condition can be life threatening, because it does not allow the blood to clot quickly, which can lead to complete non-stop bleeding. An increase in prothrombin time is not a good process. If surgical intervention is necessary, the coagulogram norm for this indicator must be observed.

The norm of the coagulogram during pregnancy

The norm of the coagulogram during pregnancy must be observed without fail. The fact is that any deviations may indicate serious problems in the body, including early detachment of the placenta, which is extremely unacceptable.

In some cases, it is not so easy to decrypt the received data. It is advisable to leave it to the doctors. Despite the fact that the indicators can fluctuate significantly during pregnancy, they should not go beyond acceptable limits. So, they have the following form: APTT - 17-20 s; Fibrinogen - up to 6.5 g / l; Lupus anticoagulant - should be absent; Platelets - 131-402 thousand / μl; Prothrombin - 78-142%; Thrombin time - 18-25 s; D-dimer - 33-726 ng / ml; Antithrombin III - 70-115%.

If the received data differs from these figures, appropriate measures must be taken. After all, all this can negatively affect the development of the fetus. Childbirth involves the loss of a small amount of blood. With poor coagulability, this is simply unacceptable. Therefore, the norm of the coagulogram must be observed.

The norm of the coagulogram in children

The norm of the coagulogram in children is practically no different from adult indicators. Thanks to this analysis, it becomes possible to determine the ability of blood to rapidly coagulate. The procedure is performed in children not so often, mostly just before surgery.

In some cases, the analysis is done even with minor procedures. This will avoid all sorts of complications and make sure that the properties of platelets work to their fullest. Any deviations can lead to blockage of blood vessels. Often, a coagulogram is performed if there is a suspicion of the presence of blood pathologies.

Normally, the indicators should not go beyond the following limits: APTT - 17-20 s; Fibrinogen - up to 6.5 g / l; Lupus anticoagulant - should be absent; Platelets - 131-402 thousand / μl; Prothrombin - 78-142%; Thrombin time - 18-25 s; D-dimer - 33-726 ng / ml; Antithrombin III - 70-115%. Such data is considered standard. The norm of the coagulogram must fully comply with the declared indicators.