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 paths, i.e., it is this time that is required for the formation of a blood clot. This test is part of a study called a coagulogram, which studies the coagulation system in more detail.
APTT blood test: normal
This study determines the time required to form a clot. In a blood test for aPTT, the norm in a healthy person is from 25 to 40 seconds. If other coagulation indicators (prothrombin, INR, fibrinogen, etc.) change, then the APTT parameter sharply reacts to this. The norm of APTT in the blood of pregnant women is 17-20 s.
Why is a pregnancy test prescribed for pregnant women?
During pregnancy, a number of physiological changes occur in the woman’s body. This also applies to blood coagulation. The blood of a pregnant woman often becomes thicker. The reason for appointing a coagulogram study is a change in the general blood test, which, after registration for pregnancy, a woman passes regularly.
If a general blood test showed an increase in the formed elements, this may indicate a thickening of the blood, and there is reason to prescribe a coagulogram, which includes the analysis of APTT. The norm of this indicator for pregnant women is somewhat different and is 17-20 s. This is due to the gradual increase in fibrinogen during pregnancy, which at the time of delivery reaches a value of 6 g / l, while in healthy 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 do occur. To avoid possible negative consequences for the child and mother, a coagulogram is prescribed.
What studies are included in the coagulogram?
The study of the coagulogram can be basic and advanced. The basic research 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, thrombosis is very likely.
- Antithrombin - refers to the anticoagulation system, and its lack can also lead to thrombosis.
- D-dimer - released during the destruction of a blood clot. Its increased amount indicates the formation of blood clots in the bloodstream.
- Lupus anticoagulant.
- ABP (activated calcification time).
- Plasma recalcification time.
- Plasma tolerance to heparin.
- RFMC (soluble fibrin-monomer complexes).
What are the indicators of the co-hologram talking about?
The APTT during pregnancy (normal 17-20 s.), Fibrinogen and other parameters, especially in the last stages, are of great importance for the prevention of complications. So, an increase in PTI (prothrombin) above 150% may indicate placental abruption. This is very dangerous for the life of the future mother and her child.
D-dimer should normally be no more than 248 ng / ml. This is in healthy people. During pregnancy, its rates 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 - gestosis, and also happens in pregnant women with diabetes mellitus or severe kidney diseases.
One of the many causes of miscarriage and miscarriages of various periods is APS (antiphospholipid syndrome), which is characterized by the formation of arterial and venous thromboses. To make such a diagnosis, antibodies to the outer membrane membrane (phospholipids) are determined, as well as fibrinogen, D-dimer, prothrombin, and APTT indicators. During pregnancy, their norm differs from normal indicators of healthy people.
Why is the homeostasis system activated during pregnancy?
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 - utero-placental.
- The 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 panic right away. Most likely, the doctor will prescribe a corrective diet. First of all, salt and all salty foods (sausages, smoked meats, pickles, etc.) should be excluded from the diet. Fatty foods are also best avoided. Instead, eat more vegetables, berries and fruits of red and orange. They are more than others rich in vitamin C, which is able to thin the blood.
It is helpful to include the following foods in your diet:
- berries (raspberries, black and red currants, mulberries, plums, strawberries, cranberries, sea buckthorn, viburnum), but you should be careful with raspberries and viburnum - these berries should not be consumed in large quantities by pregnant women;
- citrus fruits (tangerines, oranges, lime, lemon, grapefruit);
- Garnet;
- dried apricots;
- a pineapple;
- beets;
- Tomatoes
- onion and garlic;
- Birch juice;
- chocolate and cocoa;
- vegetable oils (rapeseed, olive, linseed);
- spices instead of salt (turmeric, curry, oregano, paprika, dill, cayenne pepper, ginger, thyme, cinnamon).
Products that can thicken 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 per day. But the water should be potable and without gas.
DIC
One of the most dangerous complications in obstetric practice is considered to be DIC-syndrome (disseminated intravascular coagulation). At the initial stage, hypercoagulation (increased coagulation) occurs , which is then replaced by hypocoagulation (decreased coagulation), which leads to massive blood loss and life-threatening. DIC-syndrome often acquires an uncontrolled course, and then this can lead to the death of the woman and her baby.
To avoid this 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 was no history of complications from previous pregnancies, is prescribed in each trimester. Such studies are done unscheduled in those cases if:
- At least one of the previous pregnancies ended in a miscarriage.
- There are symptoms of gestosis - 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 an examination is donated from a vein in the treatment room on an empty stomach in the morning. Pregnant women do this in antenatal clinics. For reliable indicators, several simple conditions must be observed:
- The last meal should be no later than 10-12 hours before the test.
- It is not recommended to take any medications before blood donation. If the patient is taking drugs that affect the coagulation system, this must be indicated in the direction.
- It is not recommended to drink coffee, tea, soda drinks and especially alcohol before donating blood. It is allowed to drink only a glass of clean drinking water.
- An 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.
- Muscle overstrain can distort the results of the analysis, so immediately before donating blood and the day before it is not recommended to visit gyms and engage in heavy physical labor.
For the APTT indicator, the norm in women and men is from 25 to 40 s. By gender, it does not differ, only during pregnancy, it decreases slightly. Interpretation of the results of the study is carried out only by specialists.
How much is?
Pregnant women in antenatal clinics usually do this research for free, provided that they have a seal-certified referral from a doctor. All other citizens, if desired, can undergo such a study for a fee. An expanded coagulogram costs about 3,500 rubles. Basic parameters will cost less - from 700 to 1300 rubles.
What is APTT below normal?
In the examination of the coagulation system, one of the main parameters is the APTT indicator. Its norm is from 25 to 40 seconds. Recall that this parameter shows the time required for complete blood coagulation and the formation of a blood clot. If this indicator is below 25 seconds, then this fact may indicate a thickening of the blood 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 passes independently after childbirth. In addition, iron preparations can somewhat thicken the blood, which are often prescribed to pregnant women with low hemoglobin numbers.
What does an increase in APTT indicate?
An APTT index higher than normal may indicate a person has a disease such as hemophilia, serious liver diseases, 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 coagulation factors.
- In the case of treatment of the patient with anticoagulants, for example, “Heparin” or “Warfarin”.
- With hereditary blood pathologies, for example, von Willebrand disease.
- With DIC.
Such a study of the coagulation system, as a coagulogram, is useful not only for pregnant women, but also for all people. In case of any deviations from the norm, consult a doctor.