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Hemostasiogram study in miscarriage of pregnancy
Last reviewed: 08.07.2025
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Hemostasiogram studies are the main test for detecting autoimmune disorders. Currently, the range of hemostasiological studies is quite wide, but the interpretation of the detected disorders can be complex. From our point of view, for practical work, the study of such parameters as thromboelastogram, platelet aggregation and determination of markers of chronic DIC (RCMC, PDF, dimers) is quite informative. Thromboelastography can be of whole blood, or plasma, therefore, the standard parameters depend on the devices used and should be worked out in each laboratory.
The principle of the method consists of graphic registration of the processes of fibrin formation, its retraction and fibrinolysis.
The assessment of platelet aggregation activity is carried out by photoelectric recording of the dynamics of changes in the light transmittance of the studied sample of plasma rich in platelets when mixed with aggregation stimulants: a solution of adenosine monophosphate (ADP) at a final concentration of 1x10 3 M, a collagen suspension at a final concentration of 0.04 mg/ml.
Determination of soluble fibrin monomer complexes is carried out using the protamine sulfate and ethanol test. The presence of fibrin monomers indicates the circulation of active thrombin in the blood.
Determination of fibrin and fibrinogen degradation products (FDP) is performed using a hemagglutination inhibition test using antifibrinogen serum and erythrocytes sensitized with human fibrinogen.
According to the research data and analysis of numerous literature on diagnostics of thrombophilic disorders in obstetric practice, it is necessary to raise the issue of the fact that the assessment of the hemostasis system should become a routine test in obstetric practice as blood and urine analysis before and during pregnancy. Considering the possibilities of predicting and treating severe obstetric complications (placental abruption, intrauterine fetal death, pregnancy loss in all trimesters, severe toxicosis of the second half of pregnancy, intrauterine growth retardation) according to the assessment of hemostasis starting from the early stages of pregnancy, makes these studies extremely important for the work of an obstetrician both in a antenatal clinic and in a maternity hospital. Not to mention the prevention of severe thrombophilic complications in the form of thromboembolism of coagulopathic bleeding. In the presence of a thrombophilic anamnesis, when using heparin, it is additionally necessary to conduct the following studies: determination of the number of platelets; determination of the activity of antithrombin III, proteins C and S, plasminogen.
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