Am iii analysis. Antithrombin III

Tissue damage, which happens all the time, initiates the start of a complex set of events in the body. We are talking about stopping bleeding and releasing the wound from pathogenic bacteria and bodies of foreign origin. The basis of such coagulative measures is associated with the formation of a blood clot at the site of injury. This is a blood clot that closes the wound, which means that the bleeding stops. In connection with coagulative measures, sometimes the question may arise why the antithrombin 3 level is increased, what are the reasons for this?

The main role in the process of coagulation is assigned to the protein fibrin. It is they who form a kind of skeleton on which red blood cells are collected, which is how a clot is formed. The speed at which a clot gathers and the efficiency of clotting depends on many factors. In total, there are 12 of them, and Roman numerals are used for designation. Each of the coagulation factors has a specific role in the coagulation cascade. If the indicator is lowered or increased, then a blood clot may not form correctly.

One of these factors is antithrombin III. It refers to a specific protein main function which - control over the work of some factors associated with clotting and preventing the formation of too a large number blood clots. Therefore, the analysis for antithrombin III acts as a marker of the blood coagulation process. Doctors use it when the formation and destruction of blood clots is controlled.

When performing an analysis, the norm is determined by a small amount of venous blood. Before surrendering, it is important to stop smoking, to prevent severe stress, both emotional and physical. Surrender is carried out on an empty stomach. This means that the last meal should be no later than 8-12 hours before delivery.

The norm of antithrombin III varies depending on age. At the same time, the doctor may ask for an analysis under different circumstances. Such testing is reserved for people under 50 years of age who have thrombotic episodes for which no cause is known. The analysis is performed several months after the thrombotic episode.

Testing is recommended for persons in whose family there have been cases of early vascular thrombosis, if complications of a thromboembolic nature are present. An analysis is prescribed in combination with other checks aimed at a full assessment of the blood coagulation process. At the same time, it is also performed with tests related to the anticoagulant cascade. If a person is scheduled to perform a long operation that will take from four hours, the rate is determined in without fail. Antithrombin 3 levels during pregnancy are also important, especially if there are any complications. It is necessary to determine the levels of antithrombin increased or decreased if there is not a sufficient response to heparin treatment. First of all, an assessment of the activity of antithrombin is given, and only then its amount in the blood is checked.

The rate of the indicator

If antithrombin III is increased or decreased, this can create certain health problems. The norm, however, varies depending on age. If we are talking about newborn children, then its indicator is physiologically lowered and is at the level of 40-80 percent.

If we are talking about infants and children under the age of six years, then the norm indicator is already significantly different from the first category. We are talking about normal boundaries ranging from 80 to 140 percent.

From six to 11 years, the norm changes slightly. The boundaries are reduced, the indicator should fall in the range from 90 to 130 percent. From 11 years of age to graduation adolescence normal values there will be an indicator from 80 to 120 percent. From the age of 16, the norms become the same, both for a teenager and for an adult. This figure is in the range of 75-125 percent.

It is important to understand that reference values may vary depending on the equipment used. Usually, the correct norms for your result are prescribed in the test results. It is important to take them into account, since for some laboratories the indicator can reach high numbers, but at the same time be normal.

The fact that it is antithrombin III that is being studied is not difficult to explain. The fact is that it is on him that the main share of antithrombin plasma activity is assigned. To a lesser extent, other primary anticoagulants are connected to this task. This factor acts as a thrombin inhibitor, which leads to inhibition of the active factors of the system responsible for blood clotting.

However, it is important to emphasize that AT III does not directly demonstrate high efficiency. Most of the anti-clotting system is associated with the combination of AT III and heparin.

Why does the level change

Antithrombin, like most blood components, can both increase and decrease from time to time in relation to normal values. If we are talking about an increase, then this is more often associated with the regular intake of drugs that thin the blood. In addition, the following cannot be ruled out:

acute lack of vitamin K;
acute viral hepatitis;
inflammatory processes;
menstruation.

It should be noted that if we are talking about an increase in the pathological nature, then high risk bleeding. This condition poses a danger to human health and life, and, accordingly, requires timely treatment.

Decreased antithrombin III may also occur. More often, the launch of a cascade of coagulative orientation can affect it in this way. This leads to a possible risk of thrombotic complications. This feature also appears in last trimester pregnancy. Such a feature is observed in girls in the middle of the menstrual cycle and when taking oral contraceptives or hormones. It's about estrogen.

It is also impossible to exclude such an option, in which a reduced AT III indicator acts as a symptom of the development of a complex disease. Among such a list, it is especially worth highlighting atherosclerosis, within which diseases are present on a chronic basis. of cardio-vascular system. This leads to the deposition of cholesterol on the internal vascular walls.

Congenital antithrombin deficiency, hepatic diseases, disseminated intravascular coagulation syndrome cannot be ruled out. Such a problem can manifest itself with sepsis, thromboembolism.

Scarcity Options

Low levels of antithrombin III are rare, usually their percentage does not exceed one. However, it is hereditary problems that often provoke hemostasis pathologies. Therefore, the problems of this parameter have two forms. This is congenital (0.02 percent) and acquired.

If we are talking about a congenital form, then cases of a heterozygous state with a pathological gene are implied. In this case, thrombosis can be encountered already at the age of 20-35 years. At the same time, pregnancy, childbirth, operations, problems after inflammation are the main provocateurs of pathological episodes. internal organs. It is impossible to exclude from the causes and the use of oral contraceptives. The homozygous form is extremely rare. If we are talking about her, then thrombosis manifests itself almost from the first days of life.

Acquired variants can be formed without any age binding. At the same time, to talk about some specific clinical manifestations such a syndrome is impossible. Thrombosis will be the only sign that speaks of a problem. However, this feature works for a number of problems of the hemocoagulation system.

The amount of anticoagulant in the blood is not always small, sometimes it is in the plasma in the required quantities. However, against the background of the change structural features antithrombin III is a violation of functional duties. Therefore, given such circumstances, insufficiency can be of different types.

This is the first type - quantitative. It is characterized by the lack of content of this factor. The second type is qualitative, when the level of the indicator is within the normal range, but for some reason does not cope with its direct duties, that is, there is a functional inferiority.

The cause of thrombosis may be a combination of these factors. Therefore, in order to clarify true reason, not only a quantitative but also a qualitative indicator is being studied.

The course of pregnancy

During pregnancy, a woman's body undergoes many major changes. For nine months, he has to work as a well-coordinated system, while also on two fronts. With any, even seemingly minor failures, a serious violation can occur, which will cause pathological changes during pregnancy.

To control the parameters, during the three trimesters, a woman is assigned a variety of tests and scheduled examinations. One of the most important can be considered a coagulogram. Except overall indicators, it is important for doctors to know the level of antithrombin 3.

During pregnancy, the blood coagulation system begins to work more actively. Such changes are quite understandable and act as a sign of normal developing pregnancy. The body of a woman is preparing for an increase in the amount of blood due to the appearance of an additional blood circulation circle, in addition, it is important to protect herself in case of blood loss at the time of childbirth.

When it comes to a drop in antithrombin III levels, in the case of pregnant women drug treatment is selected only in case of a strong fall. In this case, the lack of timely treatment can lead to death. The choice of treatment largely depends on the clinical picture, the indicators that are obtained in fact after a comprehensive diagnosis.

It is worth emphasizing that in the third trimester there is a tendency for a slight decrease in indicators, but this is considered the norm, so you should not worry about this. In the treatment, fresh frozen blood plasma and heparins with low molecular weight indicators are mainly used.

When tissues are damaged, the body begins a set of measures to stop bleeding and restrict access to the wound of pathogenic bacteria and foreign bodies. These measures (coagulative cascade) are based on the formation of a blood clot at the site of injury - a thrombus, which would close the wound and stop the leakage of blood from the body. The main role in this process the fibrin protein plays, which forms a skeleton around which the clot is already being created.

The rate of thrombus formation and its effectiveness depends on clotting factors. There are twelve of them, and they are designated by Roman numerals. Each of the clotting factors plays a specific role in the coagulative cascade, and a deficiency or excess of any of them can lead to abnormal thrombus formation or thrombosis.

Norm ATIII

Antithrombin III (ATIII) is a specific protein whose main function is to control the work of certain clotting factors (including thrombin) and prevent the formation of too many blood clots.

Therefore, the analysis for antithrombin III is a marker indicator of the blood coagulation process and is used in clinical practice to monitor thrombus formation and thrombosis.

For antithrombin III analysis, a small volume of venous blood is taken. It is worth noting that before undergoing the study, the patient should refrain from smoking, strong emotional and physical stress, and it is also not recommended to eat food twelve hours before the study.

Table 1. Norm ATIII

It is worth highlighting in a separate group normal performance ATIII in women during pregnancy, since when carrying a child, the blood coagulation system works much more intensively. Reference values for women during pregnancy, depending on the period, are presented in table 2.

Table 2. Norm of ATIII in women during pregnancy

Change in antithrombin level

Antithrombin in the blood can be increased and decreased. Antithrombin III is elevated for the following reasons:

regular use of blood thinners (anticoagulants), such as warfarin, heparin;
severe lack of vitamin K;
acute viral hepatitis;
inflammatory processes;
menstruation.

It is worth noting that if the level of antithrombin is pathologically elevated, then this indicates a too high risk of bleeding. This state dangerous and requires treatment.

Antithrombin III may be lowered as a result of the following diseases and conditions:

launch of the coagulative cascade, probable risk of thrombotic complications;
last trimester of pregnancy;
middle of the menstrual cycle;
taking oral contraceptives and female hormones (estrogens).

A decrease in ATIII may be a symptom of the development of a large number of diseases. Some of them:

atherosclerosis ( chronic illness cardiovascular system, characterized by the deposition of cholesterol on the inner walls of blood vessels);
congenital deficiency of antithrombin protein;
liver diseases (hepatitis, cirrhosis of the liver);
syndrome of disseminated intravascular coagulation (a serious violation of the blood coagulation system due to the ingress of thromboplastic substances into the bloodstream);
sepsis (inflammation in infectious diseases);
thromboembolism (separation of a blood clot from the place of its formation and blockage blood vessel followed by tissue ischemia).

It is worth noting that doctors distinguish two types of lack of antithrombin III in the blood. The first type is characterized by the synthesis of normal ATIII, but its level is lowered. The second type is characterized by the synthesis of a sufficient amount of ATIII, however, due to some factors, it cannot perform the proper functions.

If antithrombin III is significantly reduced during pregnancy, then this is a very wake-up call to the start of treatment. Ignoring low ATIII can lead to the development of thrombosis. According to statistics, thirty percent of patients during pregnancy die precisely as a result of the development of this disease. This means that with any deviation in the level of this protein, it is urgent to seek medical advice.

If antithrombin III is low, antithrombotic drugs are usually prescribed - low molecular weight heparins. Fresh frozen plasma is often used to replenish antithrombin levels. It is worth noting that self-administration of medications without the supervision of a knowledgeable specialist is strongly discouraged. Incorrect dosages of drugs can lead to the opposite effect - the blood will be too thin, and the clotting time will be increased, which can lead to heavy bleeding.

Antithrombin 3 is a protein of the blood plasma coagulation system. The function of this protein is to control the clotting of the thrombin protein in the system, and to resist the increased clotting and formation of blood clots that can thrombose the arteries.

What is an anti-clotting plasma system?

The anticoagulant system in blood plasma, in order to maintain the structure of the blood in a liquid form, has mechanisms that are perfectly combined with each other:

Ideally smooth intima (inner wall) of the arteries;
The intima is covered with fibrin, which is applied in the thinnest layer;
Rapid movement through the arteries of the blood circulation system;
The composition of the blood contains charges of the endothelium - with a negative electric charge, as well as shaped components that prevent the walls of blood vessels from sticking together;
The mechanism also includes blood coagulants.

Coagulants are divided into:

Preceding primary coagulants are substances that are always present in the blood plasma;
Secondary substances - their development occurs as needed.

Inactive thrombin

The antithrombin protein is found both in the primary and in the second group of coagulants of the hemostasis system.

Antithrombin also comes in several forms:

Antithrombin 2 is the protein heparin;
Antithrombin 3- this is heparin, which is part of the plasma (plasma hemostasis factor);
Antithrombin 4 are macroglobulin molecules that are the primary type of antithrombin:
Antithrombin factor 1 (fibrin) is a secondary factor that controls hemostasis in the arterial bloodstream and resists severe thrombosis.

Secondary factors resist thrombosis in the arterial bed. Antithrombin 3 is part of the coagulogram.

The value of the indicator antithrombin 3

Glycoprotein anticoagulant antithrombin 3 belongs to the physiological primary anticoagulants, which is constantly present in the blood plasma.

Synthesis of this protein occurs in liver cells and antithrombin 3 when joint work with other physiological factors, inhibits blood plasma thrombosis, which prevents thrombosis inside the vessels.

Antithrombin 3 regulates the coagulation process, slowing down the active actions of thrombin, factors of the Xa system, as well as IXa and factor Xia.

Antithrombin performs the function of the main factor in the antithrombin activity of plasma cells.

This anticoagulant is helped by the primary elements of the hemostasis system:

Macroglobulin molecules;
Antitrypsin;
Esterase anticoagulant.

Antithrombin 3, together with other anticoagulants, inhibits the activity of factors that coagulate blood:

Urokinase factor;
Factor VII;
Factor IX, as well as XII;
Plasmin molecules;
molecule of kallikrein.

At3 alone does not give the desired effect, its abilities are enhanced by the formation of an anti-thrombotic complex with heparin.

Heparin occupies 80.0% of all molecules of the system, which acts against blood plasma coagulation.

Indications for clinical laboratory testing of blood composition

The study of blood composition by the method of coagulogram is carried out in such cases:

Preventive screening of patients older than 50 calendar years, and who before that time had cases of thrombosis in the vessels;
To evaluate the quantitative composition of antithrombin and the quality of this protein;
Thromboembolic diseases of large arteries;
PE (thromboembolism of lung cells);
Ischemic stroke;
Pathology thrombophlebitis;
Complications during pregnancy - miscarriages;
Fetal fading in the first trimester of pregnancy;
Detachment of the walls of the placenta;
Pathology of eclampsia;
Preeclampsia disease;
Disease preeclampsia;
Testing blood composition for type C and type S proteins;
Lupus-type anticoagulant testing;
long surgery, which lasts more than 240 minutes;
Severe intoxication of the body;
Dehydration of the body due to intoxication, through prolonged diarrhea and a large separation of vomit;
Pathology sepsis;
state of shock;
Control over the intake of heparin preparations;
For prophylactic purposes, thrombosis of arteries in women during pregnancy and during childbirth;
Control over the state of the blood structure in patients with bed rest;
Study after surgical intervention to remove a blood clot.

How to prepare for the analysis?

To study the composition of the blood for antithrombin, only venous blood is taken by the coagulogram method (find out). Biochemical analysis is not done without prior preparation of the body, especially indicators for proteins in the structure of blood composition.

The material to be studied must be freshly taken.

In order to get the most correct value of the coagulogram in biochemistry, you need to prepare your body for the test:

Clinical laboratory analysis for antithrombin III

The Antithrombin 3 index is the basic index of the hemostasiogram technique.

According to this method, all components of the hemostasis system are determined:

prothrombin time;
APTT index;
Thrombin time index;
Quantitative indicator of fibrinogen in plasma;
Evaluation of the activity of the RKFM;
The level of work of the anticoagulant system - antithrombin index 3;
D-dimer;
Glu index in analysis;
Indicators of proteins C and S.

Normf antithrombin 3

Biochemical analysis of blood plasma composition for antithrombin 3 is a marker index of the blood plasma coagulation process. This analysis is used in clinics to control the pathologies of thrombosis, also for the destructive effect of blood clots on the vessels.

The normative index AT3 changes from birth to old age.

Reference indications of biochemistry for antithrombin 3 in this table:

Age of the subject	Reference indicators
Less than 3 calendar days	58,0 - 90,0 %
from 3 day old up to 30 days	60,0 - 89,0 %
from 30 days of age to 12 calendar months	72,0 - 134,0 %
from one year to the age of 6	101,0 - 131,0 %
from 6 years to 11 calendar years	95,0 - 134,0 %
11-16 years old	96 - 126 %
Over 16 years old	66 - 124 %

During pregnancy, the coefficients fluctuate depending on the period of intrauterine formation of the unborn baby.

Norm in women during pregnancy

Analysis price

Name of hemostasis test	Price in rubles
Index D-dimer	980
Antithrombin coefficient 3	310
APTT	170
Blood test for lupus anticoagulant	680
prothrombin time	220
Protein S index	1600
Protein C index	1580
RFMK	180
Studying thrombin time	210
Factor VIII test	880
Willebrand factor analysis	810
Fibrinogen analysis	200

The etiology of an increase in anticoagulant in the blood plasma

Antithrombin 3 is elevated, the causes cause the following pathologies:

Hepatitis in the acute stage of the onset of pathology;
cholestasis with sharp signs diseases;
Pathology of liver cells;
kidney transplant;
Deficiency in the body of vitamin K;
Inflammation in the body of an acute nature;
Violations in endocrine system, malignant formations in the endocrine organs;
Pathology of the pancreas - pancreatin disease in the acute stage;
Temporary increase in women during menstruation;
Long-term anticoagulant therapy with Warfarin.

warfarin

Enhanced Level Antithrombin 3 protein threatens dangerous bleeding.

Deficiency of antithrombin 3

Deficiency of this coagulant can be congenital or acquired. Both types lead to arterial thrombosis.

Hereditary genetic deficiency is divided into 2 types:

type 1 - the synthesis of this factor is reduced due to gene mutation;
Type 2 - the synthesis of anticoagulant is normal, only its activity is reduced.

Acquired anticoagulant deficiency also has 2 types:

Type No. 1 - a small amount of produced anticoagulant;
Type #2 is poor quality antithrombin and has no active function.

The following tests will help distinguish between a congenital deficiency state and an acquired deficiency by type:

Protein activity testing;
Test for a quantitative indicator of antithrombin - antigen.

Low index of anticoagulant in blood plasma

Antithrombin 3 is lowered, which means that the following factors occur in the blood plasma:

Treatment of abnormal anticoagulant levels

The lower index of antithrombin index 3 is variable, and there are several physiological reasons for this - this is menstruation in women, pregnancy.

The indicator of this protein must be constantly monitored, because with a sharp decrease in it, more than 30.0% of patients die due to thrombosis of large-diameter arteries.

How to raise? The basis of drug therapy for a low anticoagulant index is antithrombotic drugs.

With severe symptoms of thrombophilia pathology, drugs with low molecular weight heparins are prescribed: If the level of sodium anticoagulant is too low, heparin is not used, since there is a risk of pathology of heparin-induced vein thrombosis.

During pregnancy, the drug Clexane is used, which has low molecular weight heparins and exhibits the activity of factor Xa, as well as factor IIa.

The doctor prescribes the medication course and dosage individually and constantly monitors the anticoagulant index using the hemostasiogram method.

The dangerous period of pregnancy in terms of reducing the antithrombin index is the 2nd and 3rd trimester. During this period, it is necessary to constantly monitor the hemostasiogram.

With an increased antithrombin index 3, the drug course consists of drugs of the group - coagulants.

Complications and consequences of violations in the anticoagulant system

With an increased antithrombin index of 3, there is a greater risk of heavy bleeding during pregnancy and during childbirth. Bleeding in trauma - internal and external, most common causes lethal outcomes.

With a reduced index of this protein, there is a high probability of such dangerous pathologies that often lead to death:

Prevention

Systematic monitoring of the content of antithrombin 3 in plasma using a hemostasiogram, as well as using the coagulogram technique.

Timely correct deviations of this protein in any direction.

For normal level antithrombin 3 for prevention, take vitamins K.

Proper nutrition and adequate load on the body.

IN preventive measures take the drug - Antithrombin III. This drug It is used for congenital types of pathology, as well as for its acquired forms.

With congenital pathology, it is necessary to protect the vessels as much as possible from possible relapses of the disease. This suggests that, without urgent need, do not use methods of intravenous administration of the drug and unreasonable blood sampling.

Video: Coagulation system.

Forecast for life

A high antithrombin index of 3, as well as its low coefficient, are dangerous for humans, since in a complicated form they carry mortal danger. At timely diagnosis and competent adequate treatment, it is possible to keep this protein within the normative values.

With constant therapy and control of the hemostasis system, the prognosis is favorable.

With untimely treatment, irreversible processes of the hematopoietic system and disturbances in the blood flow can occur in the body, which are fraught with death. With a complicated form of low antithrombin index 3, the prognosis is unfavorable.

During pregnancy, a woman's body must work as a single, harmonious system. Any, even the most insignificant failure can cause serious violations and cause a number of pathologies of pregnancy. In order to keep abreast and control all changes in the body, throughout the entire period of bearing a child, a woman needs to take a variety of tests and undergo routine examinations. One of the most significant is the coagulogram. Among other indicators, during pregnancy, doctors are especially interested in the level of antithrombin 3. What is it and why does it turn out to be increased attention, we will tell further.

What do we know about antithrombin 3?

Let's start with the fact that with the onset of pregnancy, the activity of the blood coagulation system increases significantly. Such changes are quite understandable and are a sign normal flow pregnancy. The woman's body is preparing for a rapid increase in blood volume, due to the appearance of the uteroplacental circulation, as well as possible blood loss at the time of childbirth.

Screening of all indicators of the coagulogram is recommended to be done once a trimester, but if deviations from the norm are recorded during the first study, the doctor may prescribe a second screening earlier. The material for research is blood taken in the morning on an empty stomach from a vein.

Antithrombin 3 is a protein, the main anticoagulant that inhibits blood clotting processes. The percentage of antithrombin 3 is determined by the process of inhibition, that is, the binding of thrombins in your blood sample. It is extremely important that these indicators correspond to the norm - 71-115%. In the event of a decrease in antithrombin 3 during pregnancy below the norm by more than 50%, there is a threat of blood clots.

The reverse picture is also undesirable, when the level of antithrombin 3 significantly exceeds the average values. The danger of such results is that it leads to termination of pregnancy, placental insufficiency, bleeding.

Therefore, for a comfortable pregnancy, when conducting such an examination as a coagulogram, the percentage of antithrombin 3 in the blood should not be increased or decreased, but be within the normal range. However, there are a number of reasons why this condition is still violated.

Causes of an increase (decrease) in antithrombin 3

Nothing just happens in our body. There are always specific catalysts that trigger certain processes. When the level of antithrombin 3 begins to decline, the first thing to do is to find out the cause of such changes. As a rule, the following factors can provoke a decrease in antithrombin 3 in women during pregnancy, as well as in the rest of the population:

significant blood loss
congenital deficiency of antithrombin 3;
liver diseases that reduce its functional activity;
frequent surgical interventions into the body;
abuse of oral contraceptives;
oncological diseases.

In this case, there are two options for the development of a situation leading to a small amount of antithrombin 3 in a woman's body:

protein is produced, it has all the properties of an anticoagulant, but it is not enough for full implementation their functions;
protein is produced in sufficient quantities, but it is dysfunctional.

People who have a decrease in antithrombin 3 fall into a separate risk group and are under the supervision of doctors for the entire period of treatment.

The other extreme is an increase in antithrombin 3, which is especially dangerous during pregnancy. This pathology in most cases is due to:

deficiency of vitamin K in the body;
taking anabolic drugs;
diseases of the pancreas;
inflammatory processes in the human body, gaining momentum.

In order not to miss such pathologies of blood clotting, do not neglect routine examinations and examinations, even if you feel well enough.

Clinical picture of pathologies of blood coagulation

Any disease or failure in the work of specific individual body systems have their own external manifestations. When during pregnancy the level of antithrombin 3 is lowered or, conversely, there is a tendency to increase it, experienced specialists will pay attention to the following symptoms. With antithrombin 3 deficiency:

deep vein thrombosis in the legs;
intrauterine fetal death;
recurring miscarriages.

An increase in the amount of antithrombin 3 during pregnancy does not always have external manifestations. If the indicators are not critical and do not greatly exceed the permissible norm, minor deviations are corrected by diet and concomitant treatment. In the event that there is a significant difference with the average norms, additional tests are prescribed, on the basis of which drug treatment is prescribed.

Treatment of antithrombin 3 deficiency in pregnancy

Please note that targeted drug treatment is used when there is a severe drop in antithrombin 3 levels. If not taken timely treatment, then a further decrease in the anticoagulant protein is fatal for the patient.

When choosing the type of treatment, it is taken into account and clinical picture diseases and indicators obtained during complex diagnostics.

Important: in the third trimester of pregnancy, there is a tendency to a slight decrease in indicators and this is not a reason for panic, but a variant of the norm.

The main vector of treatment is aimed at taking antithrombotic drugs:

fresh frozen blood plasma;
low molecular weight heparins.

Attention: if the level of antithrombin 3 is too low, do not use sodium heparin. This is due to the fact that it causes thrombosis of various etiologies.

The dosage of drugs is set under the supervision of a hemostasiologist individually in each specific case. transition period the second and third trimesters of pregnancy are considered: antithrombin 3 levels decrease, and the coagulation potential of the blood increases.
Take care of your health and stay healthy!