| Haemostatic changes and acquired activated protein C resistance in normal pregnancy. | |
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MedLine Citation:
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PMID: 17890957 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Influence of changes in levels of coagulation factors and anticoagulants on acquired activated protein C (APC) resistance were studied in 40 healthy women during normal pregnancy. Factor VIII (FVIII), von Willebrand factor antigen (VWF:Ag), free protein S (FPS) and protein C were determined at 5-13, 14-26 and 27-40 weeks gestation and more than 6 weeks postpartum. APC anticoagulant activity was determined by measuring the activated partial thromboplastin time before and after adding human APC, expressed as the APC-sensitivity ratio (APC-SR). During the second and third gestation trimesters a significant increase (P < 0.05) in FVIII and VWF:Ag levels and a decrease in FPS levels were seen compared with the first trimester. Postpartum FVIII and VWF:Ag levels significantly decreased and FPS levels increased compared with the third trimester. Protein C levels remained unchanged during pregnancy and postpartum. Between increased FVIII and lowered APC-SR a trend of inverse correlation (r = -0.329; P = 0.076) occurred in the second trimester. No correlation was found between APC-SR and FPS or VWF:Ag levels. A remarkable finding is the strong inverse relationship between APC-SR and protein C levels (r <or= -0.392; P < 0.05) during pregnancy and postpartum. This may indicate that anticoagulant activity of added human APC measured by activated partial thromboplastin time is diminished in the presence of high endogenous protein C levels. A possible hypothesis is steric hindrance by sample protein C of APC binding sites on target activated factor V and/or cofactor protein S. The clinical significance of this finding should be determined because it complicates the interpretation of lowered APC-SR. |
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Authors:
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Boris Mahieu; Nadia Jacobs; Sarah Mahieu; Kristine Naelaerts; Francine Vertessen; Joost Weyler; Yves Jacquemyn; Marc Van der Planken |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis Volume: 18 ISSN: 0957-5235 ISO Abbreviation: Blood Coagul. Fibrinolysis Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-09-24 Completed Date: 2007-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102551 Medline TA: Blood Coagul Fibrinolysis Country: England |
Other Details:
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Languages: eng Pagination: 685-8 Citation Subset: IM |
Affiliation:
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Laboratory of Haemostasis and Haematology, Antwerp University Hospital, Edegem, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Activated Protein C Resistance
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blood* Adult Cross-Sectional Studies Factor V / analysis Factor VIII / analysis Female Humans Partial Thromboplastin Time / methods Pregnancy Pregnancy Trimesters / blood* Protein C / analysis* Protein C Deficiency / blood* Protein S / analysis Protein S Deficiency / blood Risk Factors von Willebrand Factor / analysis |
| Chemical | |
Reg. No./Substance:
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0/Protein C; 0/Protein S; 0/von Willebrand Factor; 9001-24-5/Factor V; 9001-27-8/Factor VIII |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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