Blood is the most important fluid for the human body, because it contributes to the enrichment of organs with oxygen and many important nutrients for the body. It also contributes to the accelerated removal of unwanted metabolic products. In medicine, hypocoagulation is a rather rare pathology. It is characterized by a reduced ability of human blood to clot. There are several types of hypocoagulation. They will be discussed.
Main reasons
There are several reasons for the appearance of such a rare pathology as hypocoagulation syndrome (DIC), among which the most important are:
- high level of activity, or increased concentration of anticoagulants;
- insufficient activity, or lack of procoagulants.
If we talk about the last reason for the development of hypocoagulation, then it may be due to impaired or insufficient synthesis of plasma coagulation factors, as well as thrombocytopathy. This rare pathology can be caused by certainserious diseases, mainly hepatitis, other liver diseases, as well as blood loss.
Decrease in blood clotting can occur due to some hereditary ailments, anemia, with a lack of vitamin K and folic acid in the body, as well as due to DIC. To the reasons for the deterioration of blood clotting, you can also add the effect on the body of a certain group of drugs that are used in medicine to treat thrombosis and improve the condition with hypercoagulation.
Main symptoms
Hypocoagulation is a pathology that is manifested by repeated bleeding and severe hemorrhages, which can form spontaneously or due to minor trauma. Even the simplest surgical procedures can be very dangerous for a person suffering from hypocoagulation. Clinical manifestations of hypocoagulation along the internal pathway of blood coagulation depend on the factor that caused the deterioration of blood coagulation. Bleeding may appear on the skin in the form of dots or small rashes. Hemorrhage can occur not only in the subcutaneous space, but also in the muscles and joints.
Thrombotic syndrome
Increased blood clotting and thrombosis can be due to:
- increasing the concentration of procoagulants in the blood;
- excessive activation of procoagulants, i.e. high creation of activated clotting conditions;
- decrease accumulation or suppression of anticoagulant activity;
- decrease concentration orsuppression of fibrinolytic activity.
The first type of hypercoagulation is more rare. Under normal circumstances, there are much more procoagulants in the blood than are necessary for blood clotting. But this “potential” of procoagulants is retained by the initiative of anticoagulants and fibrinolytic factors. Nevertheless, there are cases when hypercoagulation is associated with a significant increase in the concentration of plasma or platelet procoagulants (with manifested hyperprothrombinemia, hyperfibrinogenemia, thrombocytosis). The basis, as a rule, is an excessive complex of procoagulants, an increase in thrombopoiesis or a manifested hemoconcentration.
Hemorrhagic syndrome
The following mechanisms underlie the reduction of blood clotting:
- reducing the accumulation of procoagulants in the blood;
- poor activation of procoagulants;
- high density or excessive activation of anticoagulants;
- high concentration or excessive increase of active fibrinolytic factors.
Deficiency of procoagulants (1st mechanism) comes across quite often. It can be defined by thrombocytopenia, thrombocytopathy, weak or impaired synthesis of various plasma causes of clotting.
Coagulopathy of consumption
Consumption coagulopathy appears due to the active use of major procoagulants during generalized disseminatedintravascular coagulation (DIC). In this case, one form of coagulopathy replaces another: the stage of hypercoagulability (DIC) passes into the phase of hypocoagulation, and thrombotic dysgenitalism is complicated (added) by the formation of a hemorrhagic syndrome. This hybrid, complex pattern of coagulopathy is called thrombohemorrhagic syndrome (THS).
DIC in the baby
In a young child, especially a newly born one, there is a tendency to develop DIC due to subsequent hypocoagulation factors. This is:
- low levels of procoagulants, antithrombin III and plasminogen;
- rapid decompensation of microcirculation concept;
- Ineffective removal of activated coagulation conditions and fibrin degradation products (FDP) by phagocytic and fibrinolytic concept.
In numerous variants of TGS is critical, the transformation of its first phase into another takes place over tens of minutes or several hours. Often the syndrome bears a subacute character, in these cases, its duration is measured by many hours or several days.
Treatment
Undoubtedly, the ongoing violations will have a bad effect on the condition and composition of the blood, as well as, in fact, on the work of many systems. A very important quality of blood is the ability to clot. If this process is disturbed, hypocoagulation may develop.
If there is low clotting, doctors recommend performinga full medical examination and determine the cause of this violation. Treatment of this problem is usually complex and quite lengthy. If the pathology is congenital, lifelong treatment may be indicated. In an acute condition, patients are usually offered hospitalization.
Medicated treatment
For the treatment of hypocoagulation, drugs of different effects can be used. Physicians usually prescribe fibrinolysis inhibitors. These drugs can slow down the rate of blood clots and have a hemostatic effect. Treatment involves the use of coagulants isolated from donor plasma. Often a hemostatic sponge or thrombin is used. To correct the patient's condition during hypocoagulation, fibrinogen is prescribed. Indirect coagulants are also often used: for example, vitamin K, which promotes the production of prothrombin and affects fibrinogen. The synthetic analogue of this vitamin is Vikasol. It is prescribed for the correction of hypoprothrombinemia and for overdose of anticoagulants with indirect action.
To correct poor clotting, protamine sulfate is often used - a remedy isolated from the sperm of some fish. It has been shown to reduce the effects of excessive heparin use. It will be effective to transfuse plasma with the factors it contains for better clotting.
To stabilize the general condition of a person, traditional medicine should be tested for effectiveness. In addition, patients are advised to add todiet foods rich in amino acids, nutrients, folic acid, phosphorus and calcium. In any case, with developing low clotting, you should see a doctor as soon as possible.
Consequences
If any specific symptoms of hypocoagulation appear, you should immediately consult a doctor, as this can lead to many unpleasant consequences, which will be discussed below. It is very important to undergo a timely examination, which will help to identify and eliminate the causes of hypocoagulation. I must say that the treatment of such an ailment is complex and rather lengthy, and in especially severe cases, the patient may even be hospitalized.
If the examination revealed that hypocoagulation is hereditary, the patient may even be prescribed lifelong treatment with certain drugs.
So, what are the consequences of hypocoagulation? The patient first appears small, and then quite large hematomas, and they can form even with a slight pressure on the skin with a finger. In addition, a person with this bleeding disorder may complain of regular and heavy nosebleeds, as well as blood in the stool. Further bleeding can begin in the intestines, as well as in the mucous membranes of the oral cavity. In the most severe cases, cerebral hemorrhage can also occur, which can lead to very serious consequences, includingand fatal.
Hypocoagulation during pregnancy
The most severe and very dangerous complication during pregnancy is DIC, which provokes the appearance of bleeding, as well as thrombosis, and they, in turn, can lead to death. Most often in women during pregnancy, hypercoagulability is observed. And hypocoagulation in 30% of cases can be fatal in a pregnant patient, but only if the woman does not receive the necessary medical care on time.
And this problem begins with a violation of hemostasis, in which microclots form in the blood, which disrupt blood circulation. And this, in turn, leads to a significant decrease in blood clotting. In addition, the level of platelets in the blood decreases, increasing the risk of bleeding.
The speed and severity of hypocoagulation in pregnant women can be different. In medicine, several forms of development of this pathology have been identified:
- Hidden (latent).
- Recurrent.
- Chronic.
- Subacute.
- Spicy.
There is also a lightning-fast form of development of this pathology, but it is much less common. Most often, in pregnant women, there is an acute, as well as a chronic form of a decrease in blood clotting, and in the first case, pathology can occur with hypotonic bleeding. As for the chronic form of pathology, in pregnant women it occurs most often against the background of blood diseases orcardiovascular diseases.
Main causes of decreased blood clotting in pregnant women
Hypocoagulation is a pathology that often occurs in women. Those in position may also appear as a complication in inflammatory or infectious processes. Often this pathology occurs due to preeclampsia or early detachment of the placenta with the formation of a hematoma. A decrease in blood clotting may occur in pregnant women who have diseases of such important organs as the liver or kidneys.
