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Related Experiment Videos

Decrease in protein C inhibitor activity and acquired APC resistance during normal pregnancy.

H Shu1, M Wramsby, M Bokarewa

  • 1Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden.

Journal of Thrombosis and Thrombolysis
|March 23, 2000
PubMed
Summary
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During normal pregnancy, protein C inhibitor (PCI) levels decrease, correlating with increased activated protein C resistance (APC-r). This suggests a link between hemostasis and APC resistance in pregnancy.

Area of Science:

  • Reproductive Medicine
  • Hematology
  • Biochemistry

Background:

  • Protein C inhibitor (PCI) regulates coagulation by inhibiting activated protein C (APC) and other proteases.
  • Normal pregnancy exhibits activated hemostasis with depressed response to APC.
  • PCI consumption was hypothesized to decrease its levels in hypercoagulable states.

Purpose of the Study:

  • To investigate variations in PCI function during normal pregnancy.
  • To assess the relationship between PCI levels and acquired APC resistance (APC-r) in pregnancy.

Main Methods:

  • PCI activity was measured in plasma from 28 healthy pregnant women and 14 non-pregnant controls.
  • PCI levels were compared to previously determined APC-r values in the same samples.
  • Participants were assessed throughout gestation and postpartum, excluding those with Factor V Leiden mutation.

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Main Results:

  • PCI levels significantly decreased from the first to the third trimester in pregnant women (p < 0.001).
  • Postpartum PCI levels returned to those observed in non-pregnant controls (p > 0.05).
  • APC-r demonstrated a similar trend, increasing during gestation and normalizing postpartum.

Conclusions:

  • Decreasing PCI function correlates with increasing APC resistance as pregnancy advances.
  • Activated hemostasis likely serves as a connecting factor between PCI levels and APC resistance during pregnancy.
  • These findings elucidate the hemostatic changes occurring in normal pregnancy.