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Hyperkoagulační stavy v graviditě se zaměřením na problematiku umělého oplodnění
HODINOVÁ, Lenka
This thesis is focused on hypercoagulable states during pregnancy, especially on pregnancy after in vitro fertilisation. Hypercoagulable states are a group of congenital or acquired states that lead to the emergence deep venous thrombosis, sometimes associated with pulmonary embolism. Pregnancy itself is indicated as hypercoagulable state, which is important for facilitating hemostasis during the childbirth to avoid bleeding. It occurs to hemostatic changes during the pregnancy when there is increased concentration of most coagulation factors. The aim of this thesis is to compare coagulation laboratory results in women with spontaneous pregnancy and pregnancy after in vitro fertilisation. The results of patients were monitored in the ambulance of clinical hematology in hospital České Budějovice, a. s. in 2015 and 2016.
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Vliv vrozených hyperkoagulačních stavů na hladinu D-d se zaměřením na gravidní ženy
ŠTÍCHOVÁ, Zuzana
The thesis analyses the female patients' data from Clinical hematology department in České Budějovice hospital from year 2014 to 2015 and tries to statistically confirm connection between D-dimer level and hypercoagulable states described in previous bachelor thesis. D-dimer assay is due to negative predictive value and high sensitivity an initial laboratory test to rule out tromboembolic disease. However, it has low specificity. The elevated level of D-dimer is observed in conditions like infection, trauma, acute cancer, recent surgery or pregnancy and last studies showed increased D-dimer level even in combination with inherited hypercoagulable states. Thus, it is necessary to analyse the level of D-dimer in pregnant women related to specific hypercoagulable states. Moreover, the thesis analyses the influence of other factors like anticoagulation therapy on D-dimer level and tries to find connection between D-dimer level and pregnancy associated complication, birth weight or a type of delivery.
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D-dimer concentration in pregnancy
ŠTÍCHOVÁ, Zuzana
D-dimers belong to fibrin degradation products (FDP) which we can find in the blood when the blood clot is dissolved. This process is named fibrinolysis. The levels of D-dimer are higher in all conditions connected with increased coagulation activation like deep venous tromboembolis, pulmonary embolism or disseminated intravascular coagulation. So the negative results, when the D-dimer concentration is below predetermined threshold, are one of the useful ways how to rule out tromboembolic disease The problem is that the elevated D-dimer levels are observed in other conditions like infection, trauma, acute cancer, recent surgery or pregnancy. The thesis should confirm that the concentration of D-dimer in pregnancy is elevated and the D-dimer levels were established in particular trimesters. These are compared with the D-dimer levels described in contemporary literature. The levels are determined for two different tests which were used in Hematology laboratory in České Budějovice hospital at different times. Besides the viewpoint of D-dimer and gravidity the thesis also follows up different results of the two tests and their possibility of comparison.
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