The hemostatic system is complex, multicomponent and performs a lot of functions, the most important of which are stopping bleeding, maintaining blood in a liquid state, and participating in the healing of damage to organs and tissues.
It includes blood coagulation factors, biological molecules, platelets, vascular walls, as well as neurohumoral mechanisms that regulate the functioning of these factors. A disruption of the hemostasis system can occur when one or more components fail. As a result, the balance between coagulation and anticoagulation mechanisms is disrupted, with the development of certain consequences for the body.
Causes of hemostasis system disorders
There are acquired and congenital. Acquired conditions include:
- interference in the antigenic structure of platelets due to viral agents, certain medications, autoimmune processes;
- damage to the red bone marrow by ionizing radiation, tumor processes, chemicals;
- impaired vascular wall permeability due to decreased collagen synthesis;
- liver diseases, which lead to a decrease in the production of various blood clotting factors;
- lack of vitamin K.
Congenital causes of disorders of the hemostatic system include thrombocytopenia, von Willebrand disease, changes in genes that encode the synthesis of blood coagulation factors, and hereditary hypofibrinemia.
Clinical manifestations
Symptoms of disorders of the hemostatic system largely depend on which component is affected. If the predominance is on the side of coagulation factors, then a pronounced clinical picture is often absent. Typically, patients are concerned about general malaise (headache, weakness, fatigue), which is not always a reason for them to seek medical help. Characteristic symptoms of disorders of the hemostatic system appear with vascular thrombosis. In such cases, heart attack, stroke, pulmonary embolism, and disseminated intravascular coagulation syndrome may develop. These conditions result in severe consequences for the body and often cause death.
When there are disturbances in the hemostatic system that lead to the activation of anticoagulant components, the following symptoms develop:
- increased bleeding of gums;
- pinpoint hemorrhages on the skin (petechiae);
- the appearance of bruises for no apparent reason;
- If the integrity of the skin is damaged, the blood does not stop for a long time.
Bleeding can be not only external, but also internal. It is not always possible to recognize them in advance, which can also lead to serious consequences for the body.
Hemostasis test for pregnant women
The threat of large blood loss during childbirth is the main criterion that guides the obstetrician-gynecologist when prescribing a hemostasis test for a pregnant woman. However, in addition to this, a hemostasiogram can be prescribed by the doctor monitoring the course of pregnancy in the case when the patient develops gestosis or has uterine hypertonicity, there is a threat of miscarriage, or there is a delay in intrauterine development of the child. A hemostasis test is usually prescribed even if the pregnancy is multiple. When observed by an obstetrician-gynecologist in a medical clinic, a woman undergoes all necessary examinations during pregnancy.
Methods for diagnosing disorders of the hemostatic system
The following methods can be used to identify pathology:
- determination of bleeding time (according to Duke, according to Ivey, according to Lee-White);
- general blood test with formula;
- determination of platelet aggregation;
- prothrombin time (PTT) and prothrombin index (PTI);
- activated partial thromboplastin time (aPTT), etc.
Depending on the specific disorders of the hemostatic system, the doctor may prescribe both individual indicators and a comprehensive study - a coagulogram. It includes indicators such as PTT, PTI, APTT, determination of fibrinogen and D-dimer levels, etc.
In order to confirm or refute the hereditary nature of disorders of the hemostatic system, genetic testing is prescribed. You can take it in medical genetics.
Indications for hemostasis analysis
A bleeding disorder is primarily a serious contraindication for any surgery, so a hemostasis test is required before surgery. This diagnosis is also necessary for pregnant women, since during childbirth, a blood clotting disorder can pose a threat to the woman’s life. In addition, the doctor can prescribe this diagnosis in Yeysk for the following indications:
- Moderate to severe liver diseases: the liver is a hematopoietic organ.
- Diseases of the endocrine system: the blood clotting process is affected by the level of hormones.
- Pathologies of the cardiovascular and urinary systems.
- Autoimmune diseases.
A doctor may prescribe this type of laboratory diagnostics in cases where the patient has frequent nosebleeds, bleeding gums, bruises and hematomas even from a minor mechanical impact (minor bruise, pressure). For varicose veins, this test is also prescribed, as it allows us to identify the likelihood of a blood clot.
Preparing for hemostasis analysis
The described diagnosis in Yeysk requires some preparation. Blood is given for analysis in a medical clinic on an empty stomach. In addition, it is recommended not to eat food 8-12 hours before blood sampling; during this time you can drink clean, still water. On the eve of donating blood, you should avoid physical activity, stress, alcohol and medications that affect hematopoiesis. This primarily applies to aspirin and similar drugs, which should be stopped taking at least 5 days before the hemostasis test.
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Study of hemocoagulation in various patients for 50 years. Part 1
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