Fibrinogen, or coagulation factor I, is a plasma glycoprotein synthesized by the liver and, to a lesser extent, by endothelial tissue. Its levels should be carefully monitored by gynecologists during pregnancy. Fibrinogen is the precursor of fibrin — the substance necessary for blood clotting.
The concentration of fibrinogen in plasma increases in parallel with its rate of synthesis during the acute phase of inflammation of any origin, during recovery after surgery, and throughout pregnancy. In the latter case, the fibrinogen level rises gradually, month by month, until it reaches a significantly higher value. This physiological state helps protect the expectant mother from bleeding associated with childbirth.
What Is the Normal Range?
In men and non-pregnant women, normal fibrinogen levels range from 200 to 400 mg/dL. However, this reference range does not account for the changes that occur in the body during pregnancy. For pregnant women, fibrinogen concentrations up to 700 mg/dL are considered normal, while the minimum acceptable level also increases to around 400 mg/dL.
High Fibrinogen: What Causes It?
A high fibrinogen level during pregnancy is due to a state of physiological hypercoagulation. One of the most common causes of elevated fibrinogen is weight gain. There is a positive correlation between blood fibrinogen levels and body mass index (BMI) — the more weight gained, the higher the fibrinogen level.
Other possible causes of elevated fibrinogen include: burns, injuries, and/or wounds; acute infections; obesity; tumors; hepatitis; smoking; nephrosis.
What Are the Risks of High Fibrinogen?
An excessively high fibrinogen level during pregnancy must be promptly normalized. If the blood fibrinogen level exceeds 700 mg/dL, the risk of placental abruption and even miscarriage increases significantly. A doctor may recommend additional fibrinogen tests during pregnancy after bleeding episodes, abnormal thrombotic events, or if the patient has a hereditary fibrinogen deficiency.
Low Fibrinogen Level
The most common causes of low fibrinogen levels (below 250–300 mg/dL) during pregnancy are liver problems. Liver disease generally reduces fibrinogen synthesis, leading to lower blood concentrations. This condition can also result from intravascular coagulation.
There are also hereditary deficiencies that cause decreased fibrinogen production. Other conditions that may predispose to low fibrinogen levels during pregnancy include:
• malnutrition;
• eclampsia;
• anemia;
• fibrinolysis.
An excessively low fibrinogen level during pregnancy increases the risk of severe bleeding before, during, and after delivery, as well as miscarriage around the seventh week of pregnancy.
What to Pay Attention To
Fibrinogen level is a nonspecific indicator, meaning it does not point to the exact cause or location of any underlying condition. This phenomenon is usually temporary and returns to normal once the main issue is resolved.
If abnormal fibrinogen values during pregnancy are caused by specific diseases, the gynecologist at Bogolyuby Medical Center will identify the underlying causes and choose the most appropriate treatment strategy.
During pregnancy, it is important to maintain a lifestyle that supports normal fibrinogen levels: avoid excessive weight gain; perform light but regular aerobic exercise; adjust your diet to include foods rich in omega-3 and omega-6 fatty acids.
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