Blood is the most important liquid for the human body, since it contributes to the enrichment of organs with oxygen and many important nutrients for the body. It also contributes to the accelerated elimination of unwanted metabolic products. In medicine, hypocoagulation is a rather rare pathology. It is characterized by a reduced ability of human blood to coagulate. 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:
- a high level of activity, or an increase in the concentration of anticoagulants;
- lack of activity, or deficiency of procoagulants.
If we talk about the last reason for the development of hypocoagulation, then it may be due to a disturbed or insufficient synthesis of plasma coagulation factors, as well as thrombocytopathy. Certain serious diseases, mainly hepatitis, other liver diseases, as well as blood loss, can lead to this rare pathology.
A decrease in blood coagulability 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 coagulability, one 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 state of hypercoagulation.
Main symptoms
Hypocoagulation is a pathology that is manifested by repeated bleeding and severe hemorrhage, which can occur spontaneously or due to minor injury. Even the simplest surgical procedures can be very dangerous for a person suffering from hypocoagulation. The clinical manifestations of hypocoagulation along the internal coagulation pathway depend on the factor that caused the deterioration of blood coagulation. Bleeding can have dots or small rashes on the skin. Hemorrhage can occur not only in the subcutaneous space, but also in the muscles and joints.
Thrombotic syndrome
Increased blood coagulation and thrombosis may occur due to:
- increased concentration of procoagulants in the blood;
- excessive activation of procoagulants, i.e., high creation of activated coagulation conditions;
- reduce the accumulation or suppression of the activity of anticoagulants;
- reduce concentration or suppress the activity of fibrinolytic activity.
The first type of hypercoagulation is more rare. Under normal circumstances, there are significantly more procoagulants in the blood than are necessary for blood coagulation. But this “potential” of procoagulants is held back 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 thrombocytopoiesis, or manifested hemoconcentration.
Hemorrhagic syndrome
The basis for reducing blood coagulation are the following mechanisms:
- reduced accumulation of procoagulants in the blood;
- poor activation of procoagulants;
- high density or excessive activation of anticoagulants;
- high concentration or excessive increase in active fibrinolytic factors.
Deficiency of procoagulants (1st mechanism) comes across very often. It can be determined by thrombocytopenia, thrombocytopathy, weak or impaired synthesis of various plasma causes of coagulation.
Coagulopathy Consumption
Coagulopathy of consumption appears due to the active use of the main procoagulants during generalized disseminated intravascular coagulation (DIC). In this case, one form of coagulopathy replaces the other: the stage of hypercoagulation (DIC) goes into the phase of hypocoagulation, and thrombotic dysgenitalism is complicated (added) by the formation of hemorrhagic syndrome. Such a hybrid, complicated model of coagulopathy is called thrombohemorrhagic syndrome (TGS).
ICE in the baby
In a small child, especially just born, there is a tendency to form DIC due to the following hypocoagulation factors. It:
- low level of procoagulants, antithrombin III and plasminogen;
- rapid decompensation of the concept of microcirculation;
- ineffective removal of activated coagulation conditions and fibrin degradation products (PDF) by the phagocytic and fibrinolytic concept.
In many variants, the TGS is critical, the transformation of its first phase to another takes place over dozens of minutes or several hours. Often, the syndrome has a subacute character, in these cases its duration is measured for many hours or several days.
Treatment
Undoubtedly, the violations that occur will adversely affect the condition and composition of the blood, as well as, in fact, the work of many systems. A very important quality of blood is its ability to coagulate. If this process is disrupted, hypocoagulation may develop.
If low coagulation is noted, doctors recommend performing a full medical examination and determining the cause of this violation. The treatment for this problem is usually complex and quite lengthy. If the pathology is congenital, lifelong treatment may be indicated. In acute conditions, patients are usually offered hospitalization.
Drug treatment
Different drugs can be used to treat hypocoagulation. Doctors usually attribute fibrinolysis inhibitors. These drugs can slow down the formation of blood clots and have a hemostatic effect. Treatment involves the use of coagulants secreted from donated plasma. Often used hemostatic sponge or thrombin. To correct the condition of the patient with hypocoagulation, fibrinogen is prescribed. Indirect coagulants are also often used: for example, vitamin K, which promotes the production of prothrombin and affects fibrinogen. A synthetic analogue of this vitamin is Vikasol. It is prescribed for the correction of hypoprothrombinemia and in case of an overdose of anticoagulants with indirect action.
To correct poor coagulability, protamine sulfate is often used - a product secreted from the sperm of some fish. It is indicated to reduce the effects of excessive heparin use. Plasma transfusion with the factors contained in it will be effective for better coagulation.
To stabilize the general condition of a person, traditional medicine should be tested for effectiveness. In addition, patients are advised to add foods rich in amino acids, nutrients, folic acid, phosphorus and calcium to the diet. In any case, with developing low coagulation, you should see a doctor as soon as possible.
Effects
If there are any specific symptoms of hypocoagulation, you must 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 quite lengthy, and in especially severe cases, the patient can even be hospitalized.
If during the examination it turned out that hypocoagulation is hereditary, then the patient may even be prescribed life-long treatment with the use of certain medications.
So, what are the consequences of hypocoagulation? First, small and then quite large hematomas appear in the patient, and they can form even with a slight pressure on the skin with a finger. In addition, a person with such a 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 occur, which can lead to very serious consequences, including death.
Hypocoagulation during pregnancy
The most severe and very dangerous complication during pregnancy is considered to be 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, hypercoagulation is observed. And hypocoagulation in 30% of cases can lead to death 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 coagulability. In addition, the blood platelet count decreases, the risk of bleeding increases.
The speed and severity of hypocoagulation in pregnant women can be different. In medicine, several forms of the development of this pathology have been identified:
- Hidden (latent).
- Recurrent.
- Chronic
- Subacute.
- Sharp.
There is also a fulminant form of development of this pathology, but it is much less common. Most often, pregnant women have an acute as well as a chronic form of a decrease in blood coagulability, 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 or with cardiovascular diseases.
The main causes of decreased blood coagulation in pregnant women
Hypocoagulation is a pathology that often occurs in women. In those in position, it can also appear as a complication in inflammatory or infectious processes. Often this pathology occurs due to gestosis or early detachment of the placenta with the formation of a hematoma. Reducing blood coagulation can occur in pregnant women who have diseases of such important organs as the liver or kidneys.