APTT stands for activated partial thromboplastin time. This indicator refers to the study of the blood coagulation system and reflects the internal and general coagulation pathway, that is, this is exactly the time required for the formation of a blood clot. This test is part of a study called coagulogram, which studies the clotting system in more detail.
Blood test APTT: normal
This test determines the time required for clot formation. When examining blood for APTT, the norm in a he althy person is from 25 to 40 seconds. If other coagulation parameters change (prothrombin, INR, fibrinogen, etc.), then the APTT parameter reacts sharply to this. The norm of APTT in the blood of pregnant women is 17-20 seconds.
Why is an APTT test ordered for pregnant women?
During pregnancy, a number of physiological changes occur in a woman's body. This also applies to blood clotting. The blood of a pregnant woman often becomes thicker. The reason to prescribe a coagulogram study is changes in the general blood test, which, after registrationduring pregnancy, a woman takes regularly.
If a general blood test showed an increase in formed elements, this may mean a thickening of the blood, and there is a reason to prescribe a coagulogram, which includes an analysis of the APTT. The norm of this indicator for pregnant women is somewhat different and is 17-20 s. This is due to a gradual increase in fibrinogen during pregnancy, which reaches 6 g/l by the time of delivery, while in he althy people it normally ranges from 2.0 to 4.0 g/l.
In the body of a pregnant woman, some processes are not active, this also applies to hemostasis. This is normal, but deviations from the norm still happen. To avoid possible negative consequences for the child and mother, a coagulogram is prescribed.
What studies are included in the coagulogram?
Research coagulogram can be basic and advanced. The base study includes the following parameters:
- Prothrombin (PTI - prothrombin index).
- INR (international normalized ratio, i.e. the standard for determining blood coagulation).
- APTT.
- Fibrinogen.
If necessary, additional parameters can be assigned:
- Protein C - with its lack, the likelihood of thrombosis is high.
- Antithrombin - refers to the anticoagulation system, and its deficiency can also lead to thrombosis.
- D-dimer - released when a blood clot breaks down. Its increased amount indicates the formation of blood clots in the bloodmainstream.
- Lupus anticoagulant.
- ACT (activated calcification time).
- Plasma recalcification time.
- Plasma tolerance to heparin.
- SFMK (soluble fibrin-monomer complexes).
What do the indicators of the coagulogram say?
APTT during pregnancy (normal 17-20 sec.), fibrinogen and other parameters, especially in the last stages, are of great importance for the prevention of complications. Thus, an increase in PTI (prothrombin) above 150% may indicate placental abruption. This is very dangerous for the life of the expectant mother and her child.
D-dimer should normally be no more than 248 ng/ml. This is in he althy people. During pregnancy, its indicators increase. By the end of pregnancy, they can be 3-4 times higher than the initial value. This is the norm. An increase in D-dimer by more than 4 times from the initial value may indicate a serious pathology - preeclampsia, and also occurs in pregnant women with diabetes mellitus or severe kidney disease.
One of the many causes of miscarriage and miscarriage of various periods is APS (antiphospholipid syndrome), which is characterized by the formation of arterial and venous thrombosis. To make such a diagnosis, antibodies to the outer shell of the membranes (phospholipids), as well as fibrinogen, D-dimer, prothrombin, and APTT are determined. During pregnancy, their norm differs from the normal indicators of he althy people.
Why is the system activated during pregnancyhomeostasis?
The main reasons for this activation are as follows:
- During pregnancy, the hormonal background of the body changes.
- An additional circle of blood circulation appears - uteroplacental.
- A woman's body is preparing for the inevitable blood loss during labor.
Thick blood - what to do?
If during pregnancy, studies show that the blood is thick, you should not immediately panic. Most likely, the doctor will prescribe a corrective diet. First of all, s alt and all s alty foods (sausages, smoked meats, pickles, etc.) should be excluded from the diet. It is also better to refuse fatty foods. Instead, eat more vegetables, berries and fruits of red and orange color. They are richer than others in vitamin C, which can thin the blood.
It is useful to include the following foods in the diet:
- berries (raspberries, black and red currants, mulberries, plums, strawberries, cranberries, sea buckthorn, viburnum), but you should be careful with the use of raspberries and viburnum - pregnant women should not use these berries in large quantities;
- citrus fruits (tangerines, oranges, lime, lemon, grapefruit);
- garnet;
- dried apricots;
- pineapple;
- beets;
- tomatoes;
- onions and garlic;
- birch sap;
- chocolate and cocoa;
- vegetable oils (rapeseed, olive, linseed);
- spices instead of s alt (turmeric, curry, oregano, paprika, dill, cayenne pepper, ginger, thyme,cinnamon).
Foods that can thicken the blood should be completely eliminated. These include: bananas, potatoes, buckwheat, all carbonated drinks and alcohol.
You need to drink at least 1.5 liters of water a day. But the water must be potable and without gas.
DIC
One of the most dangerous complications in obstetric practice is DIC (desseminated intravascular coagulation). At the initial stage, hypercoagulability (increased clotting) occurs, which is then replaced by hypocoagulation (decreased clotting ability), which leads to massive blood loss and is life threatening. DIC often becomes uncontrollable, and then it can lead to the death of the woman herself and her baby.
To avoid such a situation, a coagulogram study is prescribed with the obligatory determination of fibrinogen, PTI, APTT, the norm of which during pregnancy is 17-20 s. Usually, such an examination, if there were no complications of previous pregnancies in the anamnesis, is prescribed in each trimester. Such studies are done unscheduled in cases where:
- At least one of the previous pregnancies ended in miscarriage.
- There are symptoms of preeclampsia - the presence of protein in the urine, swelling of the extremities, arterial hypertension.
- There is a threat of miscarriage, for example, with uterine hypertonicity.
How to take a blood test for a coagulogram?
Blood for such a study is taken from a vein in the treatment room in the morning on an empty stomach. Pregnant women do it in the women'sconsultations. For reliable indicators, several simple conditions must be met:
- The last meal should be no later than 10-12 hours before the test.
- It is not recommended to take any medication before donating blood. If the patient is taking drugs that affect the coagulation system, this must be indicated in the referral.
- It is not recommended to drink coffee, tea, carbonated drinks and especially alcohol before donating blood. Only a glass of clean drinking water is allowed.
- Emotional state can also affect the result, so it's better to sit in front of the office for a few minutes and calm down.
- Muscular strain can distort the results of the analysis, therefore, immediately before donating blood and the day before, it is not recommended to visit gyms and engage in hard physical labor.
For the APTT indicator, the norm for women and men is from 25 to 40 s. By gender, it does not differ, only during pregnancy it decreases slightly. The interpretation of the results of the study is carried out only by specialists.
How much?
Pregnant women in the antenatal clinic, this study is usually done free of charge, subject to a certified referral from a doctor. All other citizens, if desired, can undergo such a study for a fee. An extended coagulogram costs about 3,500 rubles. Basic parameters will cost less - from 700 to 1300 rubles.
What does an APTT below normal indicate?
Bexamination of the coagulation system, one of the main parameters is the APTT index. Its norm is from 25 to 40 seconds. Recall that this parameter shows the time it takes for complete blood clotting and the formation of a blood clot. If this indicator is below 25 seconds, then this fact may indicate blood clotting and the risk of thrombosis. In pregnant women, for the APTT indicator, the norm is from 17 to 20 seconds. Usually, this condition does not require treatment during pregnancy and resolves on its own after childbirth. In addition, iron preparations, which are often prescribed to pregnant women with low hemoglobin numbers, can thicken the blood somewhat.
What does an increase in APTT indicate?
A higher than normal APTT may indicate a person has a disease such as hemophilia, serious liver disease such as cirrhosis, or a lack of vitamin K. In addition, an increase in this parameter is observed in the following cases:
- With a lack of clotting factors.
- If the patient is being treated with anticoagulants such as Heparin or Warfarin.
- With hereditary blood pathologies, such as von Willebrand disease.
- With DIC.
Such a study of the coagulation system as a coagulogram is useful not only for pregnant women, but for all people. In case of any deviations from the norm, you should consult a doctor.
