Our expert says:
During pregnancy there is a natural decrease in Prot S to levels. This is one mechanism for increased risk of clotting during pregnancy. There are other acquired factors in pregnancy also contributing to the increased risk of clotting. On the other hand there are some patients who inherit a condition where they produce less Prot S or produce abnormal Prot S. This is referred to as an inherited Prot S deficiency. Your daughter might be at increased risk of developing a blood clot during pregnancy if there is an inherited Prot S deficiency in your family. I suggest that this be discussed with the appropriate doctor when she wants to fall pregnant or use oral contraceptives.
A positive D dimer test indicates that a clot has formed and that your body is in the process of dissolving the clot – fibrinolysis is taking place. After a blood clot has formed the D dimer test will normally be positive and as the clot is resolves the level should return to normal. This process takes time. Warfarin prevents any further clots from forming and extension of the already formed clot. The INR is used to test for the effect of warfarin and the result should be between 2-3. At this level the anticoagulation effect is optimal and the risk of bleeding minimal and this helps your body to naturally resolve the clot. It is therefore acceptable that the INR is within therapeutic range and the D dimer is positive.
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