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D-dimers in pregnancy. Influence Leiden mutation and anticoagulation therapy.
FELIXOVÁ, Veronika
In my work D-dimers in pregnancy, influence of Leiden mutation and anticoagulant therapy, I study the D-dimer concentration in pregnant women with Leiden mutation and the potential influence of anticoagulant therapy. In the first part I deal with theory. I describe here the process of fibrinolysis, including its activators and inhibitors that influence the process of fibrinolysis, and in which D-dimers are being created. . I deal with the division of thrombophilia, on the condition congenital, acquired and mixed. .Among congenital thrombophilic states belongs resistance to activated protein C, which in most cases is caused by mutation factor V Leiden. I describe here the emergence of this mutation, the occurrence and the risks with which this mutation is linked. The most discussed risk factor for me was pregnancy, which I mention in my work. Another part deals with anticoagulation therapy. In the methodical part I describe the quantitative determination of the D-dimer level by an immunoturbidimetric test in the Laboratory of Hematology of the Hospital České Budějovice. I split the whole process into a preanalytical, analytical, and postanalytical part. The principle of analysis is the addition of polystyrene particles covalently coated with monoclonal antibodies, where D-dimers are bound together with particles to clump and increase cloudiness. The haze intensity is measured by optical density and is directly proportional to the concentration of D-dimers. In the fourth part of my work I processed the data provided by the Hematology Outpatient Hospital of České Budějovice. These are the investigated levels of D-dimers in women with Leiden mutation and in women without the Leiden mutation. Leiden mutation is a thrombophilic condition with a negative personal history of thromboembolism. This mutation results in a breakdown of the coagulation system, which is manifested by frequent thrombotic complications. The risk of thromboembolism is higher in these patients than in the other population. In pregnancy, it is necessary to check with a hematologist. In the charts and tables I have attempted to confirm the aim of the work that D-dimers in pregnant women with Leiden mutation are higher than in pregnant women without the Leiden mutation. I have also looked at anticoagulant therapy that is recommended to patients to prevent and treat thromboembolic disease. The aim of the work that the level of D-dimers in pregnant women with the Leiden mutation is higher, compared to women without the Leiden mutation, was confirmed to me. The effect of anticoagulant therapy on the level of D-dimers is that pregnant women without anticoagulant therapy achieve higher levels of D-dimers than pregnant patients with anticoagulant therapy.
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