How to read the four coagulation reports during pregnancy

The four item coagulation report during pregnancy mainly focuses on four indicators: fibrinogen, prothrombin time, activated partial thromboplastin time, and D-dimer. Abnormal results may indicate hypercoagulability or bleeding risk during pregnancy. The assessment of coagulation function is crucial for preventing complications such as placental abruption and postpartum hemorrhage, and should be combined with dynamic monitoring of gestational age.

1. Fibrinogen: During pregnancy, fibrinogen levels are physiologically elevated, with a normal range of 4-6.5g/L. If the concentration exceeds 7g/L in the late stage of pregnancy, it indicates a tendency towards hypercoagulability, and if it is below 3g/L, attention should be paid to the risk of postpartum hemorrhage. Patients with preeclampsia may experience abnormal elevation, which requires comprehensive evaluation with indicators such as antithrombin III.

2. Prothrombin time:

The normal value of PT is 11-14 seconds. If it is prolonged for more than 3 seconds, liver function abnormalities or vitamin K deficiency should be checked. Pregnant women taking anticoagulant drugs need to be closely monitored, and the INR value is generally controlled between 1.5-2.5. Sudden PT prolongation accompanied by thrombocytopenia should alert to HELLP syndrome.

3. APTT time:

activated partial thromboplastin time reference value of 25-35 seconds, prolonged may indicate genetic coagulation disorders such as hemophilia. Shortening of APTT during pregnancy is commonly seen in hypercoagulable state, but isolated abnormalities should exclude interference from lupus anticoagulants. Twin pregnancy and assisted reproductive pregnancy should be closely monitored for this condition.

4. D-dimer:

D-dimer gradually increases from mid pregnancy and can reach 3-4 times that of non pregnancy at term. If the concentration exceeds 5mg/L, venous thrombosis should be checked, but it should be noted that false positives may also occur in normal pregnancies. Dynamic monitoring of growth trends is more clinically significant than single values.

5. Comprehensive interpretation:

The four coagulation parameters need to be analyzed in combination with indicators such as platelet count and antithrombin III. After 28 weeks of pregnancy, there is an increase in fibrinogen accompanied by a sudden increase in D-dimer, and fetal monitoring should be strengthened to prevent placental dysfunction. For those with a history of recurrent miscarriage, it is recommended to start coagulation function screening in early pregnancy.

It is recommended that pregnant women have their coagulation function rechecked every 8-12 weeks. People with high coagulation should adjust their diet under the guidance of a doctor and increase their intake of natural anticoagulant foods such as deep-sea fish and natto in moderation. Avoid prolonged sitting and engage in 30 minutes of prenatal exercises or walking daily to promote blood circulation. When symptoms such as lower limb swelling and pain, sudden headache, etc. occur, seek medical attention immediately to investigate the risk of thrombosis. Follow up on the recovery of coagulation indicators at 6 weeks postpartum, and strictly adhere to medical advice for anticoagulant therapy during lactation.