fibrinogen in the first trimester. Fibrinogen during pregnancy: violations of the norm, causes and methods of stabilization. Increasing the normal level and its causes

Blood clotting disorders can cause a tragedy for a woman in labor, because it is important that the bleeding stops quickly after the birth of the baby. That is why, during pregnancy, a woman’s clotting indicators are checked, including an analysis for fibrinogen. We will talk about what it is and what to do if its amount is increased in this article.

What it is

The mechanisms of blood clotting are quite complex and multi-stage. At each stage, the formation of a blood clot is facilitated by different substances that are synthesized by the body.

Fibrinogen is a plasma protein dissolved in the blood. As soon as the body needs to put the coagulation system on alert (a person cuts himself, burns himself, he is being operated on), fibrinogen begins to disintegrate under the action of thrombin, a special enzyme.

As a result, a fibrin monomer is formed, which precipitates in the form of threads, which “tie” the wound with a thrombus, preventing further blood loss. Fibrinogen is produced by the liver. The concentration of this important protein is an informative indicator of hemostasis. If the blood plasma is completely cleared of fibrinogen, it becomes serum.

During pregnancy, the amount of blood circulating in the body of the expectant mother increases, due to this, its composition may change. That's why testing for blood clotting criteria is important for pregnancy management and choice of tactics of delivery.

In order to prevent massive bleeding that threatens the life of a woman, it is important to know how long her blood can clot, and this helps doctors know exactly how much fibrinogen is in the blood plasma of the expectant mother.

The greatest danger during childbirth is the birth of the placenta, which is always accompanied by bleeding of greater or lesser intensity.

How is the analysis done?

The level of fibrinogen is determined in a comprehensive analysis, which is called a coagulogram or RFMK analysis. The analysis is considered necessary during pregnancy and in the prenatal period, no matter how the birth is planned - natural or by caesarean section.

There is no separate analysis for the concentration of fibrinogen - its values are studied together with other substances and blood coagulation criteria.

A blood sample is taken from the vein of the expectant mother. Before the analysis, fatty and spicy foods should be avoided for several days, and all stress factors and experiences should be eliminated, because under the influence of stress, the qualitative composition of the blood changes due to changes in the woman's hormonal background.

Blood should be taken on an empty stomach, if a visit to the laboratory is scheduled for the morning, then the last meal should be the night before.

Before the analysis, it is important not to exert yourself physically, to rest more. If the pregnant woman could not give up the bad habit of smoking, then an hour before taking a blood sample, you should refrain from smoking, since nicotine affects blood clotting factors, and the result of the analysis may not be true.

With the blood taken in the laboratory, numerous metamorphoses will occur - for a start, its liquid component is released from it, which ensures fluidity - plasma. It determines the amount of fibrinogen and other components of coagulation.

There are several ways to detect fibrinogen. Test systems, which are currently in service with almost all laboratories, can operate in different ways: stain fibrinogen in a certain color, determine its weight, and evaluate it by its chemical composition.

Most often, reagents are added to the resulting plasma, which cause processes in it that are similar to natural ones. Fibrinogen begins to “cooperate” with thrombin, filaments of febrin-monomer are formed, and it is them that are weighed and evaluated by laboratory assistants.

Sometimes the resulting threads are dissolved in a colored solution and the degree of color and concentration of the substance are evaluated. Actually, the method of conducting the analysis should not greatly worry the expectant mother, because all the test systems that are currently used give fairly high-precision results.

Norms

The body of a woman begins to prepare for childbirth in advance. Even if a woman is about to give birth for the first time, and her body has never experienced anything like this, the genetic “memory” tells you what to do and when.

That is why the level of febrinogen in the blood plasma is increased in pregnant women compared to non-pregnant women and men. Gradually, the concentration of this protein substance increases, this is especially noticeable in the second and third trimesters of pregnancy. In this way, the body prepares for the imminent blood loss that will accompany the birth of a new person.

Normal values of febrinogen during pregnancy, therefore, differ from the values accepted as the norm for other categories of patients.

Table of normal fibrinogen values for pregnant women:

A slight decrease in fibrinogen in the first trimester of pregnancy is considered completely normal.

By reducing blood viscosity, the body creates more favorable conditions for the initial stage of development of the baby in the mother's womb.

New blood vessels that connect the baby and the mother's body should not be loaded, the blood should be more fluid and flow faster. That is why the body reduces the amount of fibrinogen.

From the second trimester, as can be seen from the table, the plasma protein concentration values begin to increase. By this time, the vessels of the placenta, the umbilical cords are fully formed, they no longer need a gentle mode of operation, and the body of the expectant mother should prepare for childbirth.

In the third trimester, an additional increase in the amount of febrinogen in a woman's blood is considered normal. However, exceeding the protein level above the established upper threshold can be an alarming sign.

Reasons for the increase

If the coagulogram shows that the expectant mother has elevated febrinogen, the attending physician will definitely try to find the true cause of the bleeding disorder.

With increased fibrinogen, clotting time decreases, clot forms faster. In terms of preventing bleeding, this is very good. But blood clots can be dangerous for a woman in and of themselves.

Most common The reasons why the level of febrinogen may be higher than normal are as follows:

Toxicosis. Any toxicosis, especially if it is pronounced and occurs with nausea, vomiting, loss of appetite, causes mild (and sometimes not only mild) dehydration of the body. In response to this, the blood becomes thicker.
Inflammatory diseases, infections. If the future mother has them, then the viscosity of the blood also increases due to large losses of moisture.
Stress and physical overload. If a woman is in an unfavorable psychological situation, she is nervous, she produces a large amount of stress hormones. Almost the same thing happens with excessive physical exertion. The body reacts to the appearance of these hormones in the blood with increased "combat readiness", and the blood coagulation system is also brought into it. fibrinogen rises.
Insufficiency of thyroid function. The reduced content of hormones that this gland produces also affects the blood's ability to coagulate, the blood becomes thicker, and the risk of thrombosis increases.
Diseases of the heart and blood vessels. Ailments can be both chronic and develop for the first time during pregnancy. The analysis of RFMC in this case will not be the main one, but it will be important in the diagnosis.
Oncological diseases. Recently, unfortunately, the number of detected malignant tumors in pregnant women is growing. What is the reason, it is difficult to say. Experts tend to consider as the main version of the global restructuring in the female body, which come along with the "interesting position".

Possible consequences

"Thick" blood has not yet benefited anyone. This statement is especially true in relation to expectant mothers. A slight excess of fibrinogen protein in pregnant women can be easily corrected and does not cause great concern among medical workers. However, a significant rise in plasma protein levels above normal can cause serious consequences for both the woman and her child.

Among the most dangerous threats are spontaneous abortion and the death of the baby, thrombosis of the uteroplacental vessels and the subsequent death of the child, premature detachment of the placenta, which again poses a mortal danger.

A woman may develop thrombophlebitis. In some cases, there is a high risk of pulmonary thrombosis, which can cause the death of the expectant mother.

"Thick" blood with a high content of fibrinogen does not allow the child to receive all the necessary nutrients, due to which intrauterine growth retardation can begin, and the lack of oxygen, which the baby also receives with maternal blood through the mother-placenta-fetus system, can cause the development of a dangerous and serious condition - intrauterine fetal hypoxia.

Treatment

If febrinogen is elevated during pregnancy, this is not a reason to panic and ring all the bells. This only means that the woman needs additional examination and proper treatment.

First of all, the doctor must find out if everything is in order with the baby. To do this, the woman will be asked to pass unscheduled ultrasound scan. If the gestational age is long enough, an ultrasound scan will be prescribed to assess the speed and quality of the uteroplacental blood flow.

In the third trimester of pregnancy, the expectant mother will be offered to do an unscheduled CTGto make sure that the baby does not experience hypoxia and other problems.

To search for the cause of the increase in febrinogen, a woman will be prescribed extensive blood tests. They should show whether there are inflammatory processes, whether everything is in order with the hormonal background.

With a slight increase, it is enough to adjust the diet and lifestyle of the future mother in order to gradually lower the concentration of protein in the blood, and the coagulogram already prescribed after a short time will not show alarming results.

Correction includes sufficient drinking regimen. A woman should take as much water as the doctor allows her to make the blood thinner, but not cause swelling.

To do this, vegetables and fruits are introduced into the diet. with a high content of vitamin C. Fresh tomatoes, sea buckthorn, cranberries, viburnum berries “thinn” the blood well. If spring is in the yard, fresh natural birch sap will help well (juice in cans has nothing to do with real birch sap).

At other times of the year, stewed zucchini and cabbage will come to the aid of the expectant mother.

If the "home" correction did not help, and the next blood test showed an excess of fibrinogen, the attending physician prescribes vitamins of group B to the expectant mother, and in large dosages.

Can be used at any stage of pregnancy folic acid tablets, small doses of the most common aspirin. Usually this treatment is more than enough to lower the level of febrinogen.

If, despite attempts to normalize the level of this plasma protein, febrinogen levels do not decrease or its concentration rises, the woman is referred for a consultation with a specialist hematologist.

He will be engaged in finding out the true causes of the pathology and will prescribe one of the existing drugs - antiplatelet agents, which he considers necessary and acceptable for use during the period of bearing a child.

If before childbirth it is not possible to lower the level of febrinogen in the blood, the process of giving birth to a baby will take place under special control. In the delivery room, in addition to the obstetric team, there will be specialists in the field of hematology who will prevent tragic consequences in childbirth and support the woman with medications and methods necessary in a particular situation, including replacement blood transfusions.

Probably, only a few of us are familiar with this concept and generally heard that there is such an indicator in human blood. Hemoglobin, erythrocytes, ESR - yes. But most of us get acquainted with fibrinogen only with the onset of pregnancy. And even then - in some cases, women who accidentally found out about such a marker begin to look for information about it themselves and take the appropriate tests on their own initiative. Nevertheless, more often we begin to “dig” if the results of a study that we have received go beyond the accepted norms.

If you have increased fibrinogen in the blood during pregnancy, then you should not make any assumptions and experience tremors throughout your body. As a rule, this is a normal reaction of the body to bearing a child. But complications and disorders in the course of pregnancy, accompanied by a high level of fibrinogen, are certainly not excluded. Therefore, only a specialist has the right to decipher the analysis! The doctor will be able to assess the severity of the situation and, if necessary, take adequate measures to eliminate the detected problems.

What threatens an increase in fibrinogen during pregnancy: consequences

One of the most important criteria during the period of bearing a child is hemostasis, that is, the state of the blood coagulation system. The viscosity of the blood (how rarefied or condensed it is and what clotting abilities it has) determines fibrinogen, the level of which is shown by a special analysis - a coagulogram.

Fibrinogen is a protein that, when cleaved, forms fibrin. The latter, in turn, is involved in the formation of a blood clot. This mechanism provides the natural protection of the body from significant blood loss. In the place of violation of the integrity of the vessel with the participation of fibrinogen, a blood clot is formed, which prevents the onset of bleeding. This is a very "useful" substance, but with its excess or insufficient formation, it becomes "harmful".

Today we will talk about the dangers of high fibrinogen during pregnancy.

Normally, its amount in the blood ranges from 2-4 g / l (each laboratory has its own limiting norms, so it is impossible to compare analyzes performed in different places!). But with the onset of pregnancy, this figure begins to increase, reaching its maximum of 6 g / l by the end of the term. Such a physiological increase in the level of fibrinogen in the blood during pregnancy allows the female body to avoid large blood loss during childbirth.

However, with excessive formation of fibrinogen, there is a risk of miscarriage and termination of pregnancy, intrauterine death of the fetus, delays in its development, as well as the formation of thrombophlebitis and thrombosis in a woman. Such consequences are due to the fact that thick blood (which is observed with high levels of fibrinogen) leads to an increased risk of clots in the bloodstream. These clots interfere with the normal flow of blood through the vessels, but due to the thick consistency, it circulates worse. This means that oxygen and nutrients cannot reach the fetus properly, and without them, the normal development of the child becomes impossible.

Why high fibrinogen during pregnancy: reasons

There are some conditions in which the level of fibrinogen in the blood can increase. It can be:

acute infectious diseases;
inflammatory processes;
burns;
hormone therapy with estrogens;
recent surgery;
the process of tissue death;
hypothyroidism;
amyloidosis;
myocardial infarction;
stroke;
malignancies, etc.

In many women, thick blood is their physiological feature, that is, fibrinogen in their blood was increased even before conception, but the woman might not have known about it.

What to do if the level of fibrinogen is increased during pregnancy: treatment

There are a number of foods that can thin the blood. And doctors will recommend introducing them into the diet in the first place (taking into account tolerance and the absence of allergic reactions):

seafood;
seaweed;
cucumbers;
tomatoes;
beet;
red sweet pepper;
strawberry;
pomegranate;
lemon;
grapefruit;
sunflower seeds;
red grape juice;
cranberry broth;
green tea;
cocoa;
chocolate, etc.

However, it is not always possible to solve the problem of thick blood only by correcting the diet. If fibrinogen is greatly increased during pregnancy, then treatment in this case will be necessary. And here, doctors urge expectant mothers to take the situation with all responsibility and not waste precious time experimenting with traditional medicine methods: the risks are very high.

Therapy for elevated fibrinogen includes vitamin (in particular group B) and blood-thinning drugs (Kurantil, Aspirin). Many women are frightened that injections are made in the stomach. But this is no more scary than injections in the buttock, and in no way harms the baby. On the contrary: by refusing such treatment, the mother puts her pregnancy at very high risk.

It should also be noted that competent treatment for elevated fibrinogen is based on the data of a comprehensive examination. This should ideally be done by a hematologist working with pregnant women. And in order to draw up a correct effective scheme, he needs to have additional data on hand, mainly the results of a hemostasiogram and an analysis for d-dimer. It is also useful to bring the results of prenatal screening with you to the appointment.

Therefore, you should pass all the necessary tests, consult a specialist and, without any fear, begin treatment that will help you safely bear the desired baby.

Women who had high fibrinogen during pregnancy confirm with numerous reviews that it was thanks to the treatment that they managed to avoid undesirable consequences.

Especially for - Margarita SOLOVIEVA

With the onset of gestation, many women encounter a coagulogram for the first time.

If you are worried about why fibrinogen is elevated during pregnancy and why it is needed in the body, the article will answer all your questions.

What is the function of fibrinogen and how to determine its level

Fibrinogen is a protein produced by hepatocytes. It stimulates the production of hormones, bile acids, insulin and progesterone. During pregnancy, the indicated blood coagulation factor is considered one of the most important indicators of the hemostasiogram.

To switch to the active state, the protein needs to go through a cascade of chain reactions: fibrin monomer arises from fibrinogen, which, under the influence of factor 12, is converted into a fibrin polymer.

In this case, the damaged vascular walls are strengthened with the formation of a blood clot, in which the substance acts as the basis of a thrombus. After some time, fibrin is cleaved under the action of fibrinolysin, small substances appear, which are gradually absorbed in the body.

Doctors throughout pregnancy monitor the content of the indicator, as it shows the degree of thrombosis, which is especially important during delivery. Blood clots reduce blood loss as the baby exits the womb. At the same time, fibrinolysis during gestation is slowed down.

To make the test more informative and help the doctor prevent possible complications, follow the necessary conditions:

Donate blood in the morning on an empty stomach. You can not take the study, having eaten, and one hour before taking the analysis, drink juices, tea or coffee. On the eve of the hemostasiogram, it is advisable to have a light meal for dinner, excluding fatty foods 2 days before the test.
Before the coagulogram, try not to do hard work and not burden the body. Try to get good sleep.
If you are taking anticoagulants, you should tell your doctor about it.
Drink 1 glass of pure water 1-2 hours before the examination.

To determine the indicator, the pregnant woman comes to the treatment room, where venous blood is taken. The specialist pulls the forearm with a tourniquet, after which, at the site of the elbow bend, inserts a needle into the vein, drawing blood into special test tubes. After the procedure, the expectant mother pinches the injection area, and the nurse turns over the container with the material many times to prevent the formation of blood clots in it.

To determine the content of the indicator according to Clauss, laboratory assistants do not use the manual method, since this does not ensure tight fixation of the formed thrombus. For this purpose, special coagulometers are used.

What should be the level of fibrinogen during pregnancy

After fertilization has occurred, the indicator grows, reaching its maximum value in the 3rd trimester. Specialists use a fibrinogen concentration table showing its rate in each trimester.

In the first trimester

At the beginning of gestation in the early stages, the protein content practically does not differ from the norm outside of pregnancy, slightly exceeding the indicated value.

Its concentration should be in the range of 2.3 -5 g / l.

In the second trimester

In the third trimester

With the onset of the final weeks of pregnancy, the concentration of the indicator reaches 5.0-6.2 g / l.

What is the danger of increasing fibrinogen

Despite the physiological increase in the content of the substance, too high values of the indicator provoke the formation of a large number of blood clots. This means that they can disrupt blood circulation in various organs, leading to serious complications, and in some cases, death of the expectant mother and fetus in the womb.

The most dangerous adverse effects are:

the development of spontaneous miscarriage with the formation in the future of habitual miscarriage and infertility;
fading pregnancy;
the occurrence of premature detachment of the placenta;
the formation of thrombosis in the umbilical vessels, which, depending on the size of the blood clot, lead to intrauterine retention of the fetus or its death;
development of late preeclampsia at the end of pregnancy;
the appearance of thrombophlebitis in a pregnant woman;
PE (pulmonary embolism) is a serious condition that almost always threatens to kill a woman.

To prevent complications, all 9 months of a pregnant woman, it is necessary to do a hemostasiogram three times to control the content of the indicator. At the end of the term, based on the results of the analysis of coagulation factors, the doctor concludes how prepared the female body is for the upcoming labor activity and whether the development of thrombosis is likely.

Possible causes of deviation from the norm

An increased content of fibrinogen is associated with the occurrence of the following pathological processes during pregnancy:

Activation of a bacterial or viral infection - SARS, influenza, pneumonia, meningitis.
The appearance of malignant neoplasms.
Diseases of the thyroid gland with the subsequent formation of hormonal imbalance.
thrombophilia.
Rheumatism.
Diabetes.
Tuberculous damage to the body.
Prolonged toxicosis with vomiting up to 21 weeks.
Dehydration.
Smoking.

The reasons for the low content of the indicator during pregnancy, experts most often call:

the formation of late gestosis;
avitaminosis of vitamin B12 and C;
development of DIC;
diffuse liver damage - hepatitis, cirrhosis;
hematological diseases;
irrational nutrition;
weakening of the immune system.

How to lower fibrinogen during pregnancy - treatment tactics

Based on the protein content in combination with other indicators of the coagulogram (factor 7, 8, 10, 12, D-dimer, 12-a dependent fibrinolysis factor, FMCF), the doctor evaluates coagulation and, if there are deviations, takes measures to correct them.

Do not self-medicate: various pregnancy forums post all sorts of ways to deal with high fibrinogen. However, such actions are dangerous for you and the baby, since the treatment is individual for each expectant mother. All that is required is to strictly follow the doctor's recommendations and appointments, helping to eliminate the problem under the guidance of a specialist.

If during gestation the indicator is too high, the doctor prescribes a consultation with a hematologist.

To lower the level, the following drugs are most often prescribed:

Anticoagulants. These drugs inhibit the activity of blood clotting and prevent the development of excessive blood clots. The doctor selects drugs based on the risk of teratogenic effects on the fetus. Most often during pregnancy, Heparin and low molecular weight heparin - Fraxiparin, Enoxiparin are prescribed. They allow you to reduce thrombotic activity, but at the same time they do not pass through the placental barrier, therefore they are deprived of the ability to harm the baby.
Antiplatelet agents. They are used to eliminate thrombophilia and prevent the formation of thromboembolic complications.
Vitamin P: strengthens the walls of blood vessels and inhibits the action of enzymes that disrupt blood clotting.

You will have to adhere to a special diet, the products of which lower the content of the indicator in plasma.

You can eat:

raw sunflower seeds;
raspberries;
natural dark chocolate;
fruits: pomegranate, grapefruit;
vegetables: cucumbers, tomatoes, beets;
seafood;
melon;
seaweed;
green tea;
fish fat.

Decoctions of chestnut, peony and cranberry help well, lowering the concentration of fibrinogen in plasma.

Eating foods high in vitamin E also leads to normal coagulation. It is found in whole grains, sunflower oil, liver.

If therapeutic measures do not lead to the expected effect, and the blood level cannot be stabilized, the risk of thromboembolic complications is high. For this reason, delivery will take place in special conditions with the participation of an experienced medical team.

Preventive measures

The following measures will help prevent problems with high fibrinogen content:

Pregnancy planning with a preliminary determination of the content of blood coagulation indicators: fibrinogen, D-dimer, 12a dependent fibrinogen factor, etc.
Make dietary adjustments by limiting the intake of foods that increase fibrinogen or contain vitamin K due to its ability to thicken the blood (cauliflower, green leafy vegetables).
Drink plenty of fluids, especially in the summer.
Timely take tests and pass the necessary examination.
Visit your doctor regularly and follow all his orders.
Give up bad habits - smoking, drinking alcohol.
Do not be nervous, try to avoid stressful situations.
Spend more time outdoors.

What is dangerous violation of hemostasis, the doctor will tell in this video:

Conclusion

With the onset of pregnancy, the body, using the hemostasis system, prepares to prevent blood loss during childbirth. During this period, there is an increase in the content of most coagulation factors with a simultaneous decrease in fibrinolytic activity.

Such blood coagulates much faster. However, with high levels of the blood coagulation system, in particular, fibrinogen, the risk of developing thrombosis increases, which is dangerous for the health and life of a future mother with a baby. Timely medical measures can protect the pregnant woman and the fetus from the development of adverse effects.

From school, we all know that one of the most valuable components of the human body is blood. I think each of us at least once thought, looking at a scratch or cut, what makes the bleeding gradually stop?

One of the devices aimed at preserving this precious fluid is the hemostasis system or blood coagulation system. The first teachings about this complex physiological process were described by the Soviet scientist G.F. Lang in 1939.

Now we know that hemostasis is a complex of reactions aimed at stopping bleeding in case of vascular injury. All these numerous transformations are regulated by a huge number of proteins, enzymes and catalysts, one of which is fibrinogen, which will be discussed in our article.

Fibrinogen and blood coagulation

Information So, fibrinogen is a protein produced by the liver and turns into insoluble fibrin - the basis of a clot during blood coagulation. Later, blood cells “stick” to the fibrin matrix, the clot stabilizes and forms a full-fledged thrombus.

Method for the study of fibrinogen

A laboratory test for blood clotting is called. In this test, you can determine both fibrinogen and several other important indicators of hemostasis. Venous blood is most often used to determine the level of fibrinogen.

To obtain the most accurate results, the patient must:

Donate blood on an empty stomach (last meal not earlier than 12 hours before the study);
Exclude physical activity and within 1-2 hours;
Not within 30-40 minutes.

Next, the laboratory assistant places the blood drawn with a syringe into a special test tube, the walls of which are treated with a solution of citric acid salts. This is necessary to prevent clot clotting. From the received portion of blood, its liquid part, plasma, should be obtained, which is needed for the study of fibrinogen. Laboratories use a variety of test systems and determine fibrinogen by different methods:

optical;
Colorimetric (color);
by weight;
Immunochemical.

Fibrinogen indicators and their significance

The laboratory norm of fibrinogen is 2-4 grams per liter (hereinafter g / l). At certain points in life, its level can both fall and rise. So you can observe a significant increase in fibrinogen with:

myocardial infarction;
Strokes;
Acute inflammatory diseases;
burns;
malignant tumors;
When taking hormonal contraceptives.

A drop in fibrinogen levels can be observed with:

DIC syndrome;
Liver diseases (hepatitis, cirrhosis);
Malignant diseases of the blood; lack of vitamins C and B12;
Eating disorders;
Severe toxicosis of pregnant women.

One of the physiological reasons for the increase in the content of fibrinogen is pregnancy. During this crucial period, the body of the expectant mother is completely rebuilt to ensure the normal course of pregnancy and its successful outcome. During normal childbirth, a woman loses about 250-300 ml of blood, during caesarean section - about 750 ml, and during pathological childbirth and a complicated course of the postpartum period, the loss can be liters. The blood coagulation system fully directs its efforts to prepare for future childbirth - light or heavy.

Additionally The level of fibrinogen progressively increases, reaching 6 g/l in the 3rd trimester.

Looking at the table, you can observe the dynamics of the growth of fibrinogen levels . In the first trimester, we see a slight decrease in the level of fibrinogen, which is easily explained by early toxicosis of the first weeks of pregnancy, lack of appetite, frequent nausea and vomiting.

Fibrinogen increase

However, an excessive increase in the activity of the coagulation system can also be dangerous for the expectant mother and child.

High levels of fibrinogen and activation of the coagulation system lead to:

infertility;
in the early stages;
Thrombosis of the umbilical cord vessels;
Gestozam;
Thrombosis and thrombophlebitis in the mother.

One of the most formidable complications of pregnancy is pulmonary thrombosis, which most often leads to death. In this regard, the pregnant woman takes a hemostasiogram several times during the observation period. At the beginning of pregnancy, this analysis reflects the initial level of fibrinogen and other indicators of coagulation. Toward the end - how ready the body is for childbirth and whether there is a danger of thrombosis.

The attending physician may prescribe additional tests for the expectant mother in case of unsatisfactory indicators of the usual hemostasiogram. These laboratory tests include determining:

Various clotting factors;
clotting time;
The number of specific antibodies.

In any case, such patients should not be left without attention.

With small deviations, the doctor most often observes a woman, prescribes extended tests and a control hemostasiogram. At this stage, the matter is fixable by prescribing high doses of folic acid, B vitamins, microdoses of aspirin, antiplatelet agents (dipyridamole, pentoxifylline). In case of more severe disorders, high levels of fibrinogen and D-dimers, detection of antiphospholipid antibodies or hereditary diseases of the hemostasis system, a woman should definitely consult a hematologist. Further management of pregnancy will only be joint with a hematologist, who will regularly monitor the patient and adjust the treatment. Childbirth in such women should take place in specialized clinics under the supervision of qualified doctors and midwives.

Decrease in fibrinogen

With a decrease in the level of fibrinogen in pregnant women, obstetrician-gynecologists rarely encounter. One of the most common causes of low fibrinogen is severe vomiting of a pregnant woman (up to 20-25 times a day) in the early stages. This condition is called severe toxicosis and requires treatment in the department of pregnancy pathology. Another extremely serious reason for the decrease in fibrinogen is the last stage of the DIC syndrome (disseminated intravascular coagulation), when the body has used up all its coagulation factors, including fibrinogen. DIC syndrome develops against the background of:

massive bleeding;
Severe intoxication;
traumatic operations;
burns;
infections;
Embolism with amniotic fluid;
Eclampsia;
Errors in blood transfusion.

Such patients develop severe external and internal bleeding, the fight against which is often doomed to failure. Fortunately, such complications in obstetrics are rare and a team of resuscitators and transfusiologists is involved in saving the lives of such patients.

The fulfillment of all the recommendations of an obstetrician-gynecologist and a hematologist by a pregnant woman reduces the risk of severe complications to a minimum. A huge amount of knowledge and skills of modern doctors helps to give birth to babies even in hopelessly difficult cases. Expectant mothers should remember that their happiness and health is the key to the happiness and health of their children.