Rus Articles Journal

Blood tests. What and when?

From all analyses which should be handed over to future mother blood tests are among the most important and informative. Blood - unique body tissue which gives the chance to estimate functions nearly of all its bodies and systems and during pregnancy allows to obtain information also on work of an organism of future kid.

the General blood test

Blood is the opaque liquid body tissue of the person of red color consisting of plasma and so-called uniform elements of blood - erythrocytes (red blood cells), leukocytes (white blood cells) and platelets. Research of these indicators is possible at blood sampling (both from a finger, and from a vein) on the general (clinical) blood test. Each of the listed elements of blood carries out the certain function, and at interpretation of the received results all these indicators are important, especially so far as concerns health of future mother and her kid.

Erythrocytes and the hemoglobin which is their part carry out oxygen transport in bodies and body tissues of the person, and during pregnancy - and to future kid. Change of these indicators, both towards increase, and towards reduction, gives a reason for further profound inspection of future mother for clarification of the reasons established changes.

Clinical (general) blood test for the entire period of pregnancy without fail should hand over

not less than 3 times - at registration (till 12 weeks of pregnancy) and further in each trimester of pregnancy - on term 18 × 30 weeks that in each of the specified periods to watch important indicators of this analysis. However there can be a need to repeat this research and before childbirth. Especially important it when earlier changes were revealed and the correcting therapy was carried out. At identification of changes of any indicators by the doctor the repeated blood test after correction of the revealed changes will be appointed. Blood for the general analysis is taken away from a finger or from a vein, it is necessary to make the test on an empty stomach.

Research on HIV, hepatitises, syphilis

One more obligatory blood test conducted for the entire period of pregnancy not less than 3 times are research on HIV, hepatitises B and C and research on syphilis. The blue blood is necessary for this research. A blood test also should be taken on an empty stomach. These researches are conducted in each trimester of pregnancy.

many future mothers have a question: why to pregnant women to be examined on such terrible infections moreover it is so frequent? All the matter is that at hit of an infection in an organism signs in blood appear within at least 3 months - here from where such time interval. And to secure itself against hit on childbirth in observation office where put the women who are not examined, so, various infections making risk group on existence, future mother should observe all terms of delivery of similar analyses.

Biochemical blood test

One more analysis which needs to be handed over during pregnancy is biochemical blood test. By means of this research functions of bodies and systems of an organism of the woman are estimated. Obligatory (MZ Russian Federation supported by normative documents) this research is not, however if future mother has chronic diseases of internals (chronic pyelonephritis - an inflammation of kidneys, chronic cholecystitis - an inflammation of a gall bladder, chronic gastritis - an inflammation mucous a stomach and so forth) it is necessary to carry out it. And as during pregnancy load of work of all organism increases, to conduct this research very important in time to diagnose an exacerbation of a chronic disease therefore the first time “biochemistry“ of blood needs to be handed over at registration in a maternity welfare unit, repeatedly - in 18 - 20 × 30 weeks of pregnancy if there was no need of carrying out this research in other terms.

For the biochemical analysis blood is taken from a vein, strictly on an empty stomach for an exception of possible inaccuracies in measurement.

by means of this analysis various exchange processes in an organism of future mother (carbohydrate, lipidic, proteinaceous) estimate, function of an urinary system (kidneys, a bladder), a liver and a gall bladder. From a huge range of biochemical researches and informative the proteinaceous composition of blood (albumine and proteinaceous fractions), serumal iron and the general iron-binding ability of serum (these indicators are important for diagnosis of anemia of pregnant women), urea, uric acid, creatinine and electrolytes of blood (potassium, calcium, magnesium, sodium), ALAT, ASAT, alkaline phosphatase are the most important. However taking into account clinical manifestations and weight of chronic process the range of researches can be considerably expanded.

One of important biochemical analyses is determination of level of sugar (glucose) in blood of the pregnant woman. Especially it is worth paying attention to women with the increased body weight before pregnancy to this research, and also to women with a pathological increase in weight during pregnancy, i.e. to the women making risk group on developing of diabetes of pregnant women (gestational diabetes).

Koagulogramm`s

Koagulogramm`s

allows to reveal features of violation in system of a hemostasis at the pregnant woman and some complications of pregnancy and, therefore, to carry out the correct treatment. The hemostasis is a set of components of blood vessels and blood which interaction provides maintenance of integrity of a vascular wall and a stop of bleeding at damage of vessels.

should hand over

to Koagulogramm time in a trimester, and in the presence of deviations of indicators of a hemostasis - is more often, on doctor`s orders. Blood for the analysis is taken from a vein in the morning on an empty stomach.

Key parameters of a koagulogramma

Fibrinogen - protein, the predecessor of the fibrin making a clot basis at fibrillation.

of AChTV - the activated partial tromboplastinovy time. This time of fibrillation depending on presence of factors of folding.

the Treating doctor will prompt to
optimum combinations of the made tests.
Volchanochny anticoagulant - normal should not be produced by

at the pregnant woman. It is group of antibodies (IgM and IgG) to an external cover of platelets. These antibodies appear at autoimmune diseases (when work of immune system is directed against own bodies), at pregnancy pathology (a gestoza - the complication worsening a condition of mother and a fruit and which is shown increase of arterial pressure, emergence of hypostases, protein in urine).

the Trombinovy Time (TT) is time of the last stage of fibrillation: formation of fibrin from fibrinogen under the influence of thrombin.

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the Prothrombin - this indicator is defined as a percentage as allows to define activity of a protrombinovy complex of plasma of the patient in comparison with the measured protrombinovy time of control plasma.

Antitrombin III is a protein of the anticurtailing system, thrombin inhibitor. It has the oppressing effect on fibrillation processes.

D - dimeasures is an indicator of a tromboobrazovaniye and a fibrinoliz (fibrin dissolution).

Platelets are the uniform elements of blood participating in providing a hemostasis.

Group

blood and a Rhesus factor - a factor

At registration in a maternity welfare unit future mother channelize

on definition of a blood type and a Rhesus factor - a factor. It is necessary even in case the woman knows the blood type and it has a stamp in the passport. This research once is conducted. But it is necessary to know that if future mother has a negative rezusny accessory of blood, then future father needs also to pass similar research. In case of identification at the father positive a Rhesus factor - a factor the Rhesus factor - negative mother is necessary to 20 - y weeks of pregnancy to take a blood test on existence of antibodies and for definition of their caption (quantity) once a month, and after 20 - y weeks - to conduct this research at least 1 time in 2 weeks or to destination the attending physician. Thus, it is necessary to take a blood test from a vein on definition of a caption of antibodies 10 - 12 times for all pregnancy.

Research on TORCH - an infection

of TORCH - an infection is the reduced name of the most often found pre-natal infections dangerous to a fruit. TORCH - Toxoplasma (toxoplasmosis), Rubella (rubella), Cytomegalovirus (cytomegalovirus), Herpes (herpes). Diagnose TORCH - infections, investigating blood on existence of antibodies to the corresponding activators. At the same time define credits (quantity) of antibodies to the listed activators. If antibodies are, it does not mean that future mother is surely sick. It can mean that she once had this infection and has to it immunity. However if the caption of antibodies to a certain infection is very high or accrues over time, it already testifies to activity of process. And clinically the illness can not be shown or shown by the soft, erased forms that can be especially dangerous to pre-natal development of the kid.

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Blood test on TORCH - the complex is carried out at the first visit by the pregnant woman of the doctor of a maternity welfare unit. And of course, the number of similar researches is difficult predicted as at detection of a high caption of antibodies to any of the listed infections researches in dynamics are necessary to have an opportunity to control process of a course of a disease and to carry out treatment.

Diagnosis of genetic pathology of a fruit

On early terms of pregnancy, since 8 - 9 - y weeks, a marker of genetic pathology of a fruit is definition of PAPP - a squirrel (placentary globulin) in blood of the pregnant woman. Definition of PAPP is effective in diagnostics of anomalies of a fruit at the combined definition with a free subjedinitsa of a horionichesky gonadotrophin on terms of pregnancy of 10 - 14 weeks (the double test). For these analyses the blue blood is used. The term of carrying out this research is important for early diagnosis of malformations of a fruit as if after careful additional research the estimated diagnosis is confirmed, pregnancy interruption, which, certainly, more safely and less traumatic, than interruption of pregnancy on later terms is necessary.

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of the Schedule of delivery of obligatory blood tests during pregnancy
At registration: general blood test;
blood on AIDS, syphilis, hepatitises B and C;
biochemical blood test;
koagulogramma;
a Rhesus factor - a factor, a blood type;
TORCH - infections.
In 11 - 14 weeks: prenatal biochemical screening (double test). If registration is carried out about 10 weeks in time, then earlier specified tests can be made in the same time.
In 16 - 20 weeks: prenatal biochemical screening (threefold test);
general blood test;
blood on AIDS, syphilis, hepatitises;
biochemical blood test;
koagulogramma.
In 30 weeks: general blood test;
blood on AIDS, syphilis, hepatitises;
biochemical blood test;
koagulogramma.

One more hormonal research during pregnancy is determination of the β levels; - HGCh, AFP and an estriol (E3) - the so-called threefold test which assumes research of markers of malformations and genetic pathology of a fruit. This research is conducted once in an interval with 16 - y on 20 - yu week of pregnancy about use of a blue blood of the pregnant woman.

Separately would like to stop on a question of hormonal inspection during pregnancy, namely - on research of function of a thyroid gland that is especially important if before pregnancy the patient had any problems in this sphere. Therefore such women need to control the thyroid glands function throughout all pregnancy, but especially it is important on early terms of pregnancy when there is laying of nervous system of future kid which change of amount of hormones of a thyroid gland can negatively affect. For this purpose on early terms of pregnancy the blood test on the following hormones is conducted: tireotropny hormone (TTG), tiroksin (T4), triyodtironin (T3), in certain cases - antibodies to a tireoglobulin (AT TG). This inspection is not obligatory, but many doctors consider it necessary for all future mothers, considering that a large number of women receive insufficient amount of iodine which is so necessary for normal functioning of a thyroid gland with food, and also the fact that often the disease proceeds is erased. According to indications the doctor can appoint and other analyses. In conclusion it is necessary to tell that, at first sight, there is a lot of blood tests which need to be carried out during pregnancy. But it not absolutely so. Many researches combine, i.e. it is at the same time possible to make the biochemical test, research of a hormonal background of the woman etc. Certainly, the treating doctor will prompt optimum combinations of the made tests depending on the course of pregnancy, existence of indications to them. But it is necessary to hand over them all!

Should note

that the wide interval of standard values of any indicators is caused by use of different reagents by different laboratories, and also various external influences (the used analyzers, nature of food of the patient the day before and in day of research, ambient temperature), completely which it is not possible to exclude, as a rule. Therefore it is recommended to conduct researches in one laboratory to avoid nervousness apropos of the “wrong“ results.