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A comparative study of the protein C system in mother's blood, cord blood and amniotic fluid
Mieczysław Uszyński1, Waldemar Uszyński, Ewa Zekanowska
1Department of Propedeutics of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland. kizproped@cm.umk.pl
Insights
This study compared protein C system components in maternal, cord, and amniotic fluid. Protein C and S levels were highest in mothers, while thrombomodulin and TAFI were highest in cord blood.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Perinatology
Background:
- The protein C system, including protein C (PC), protein S (PS), thrombomodulin (TM), and thrombin activatable fibrinolysis inhibitor (TAFI), is crucial for pregnancy.
- Dysregulation of this system is implicated in pregnancy complications like preeclampsia and affects uteroplacental circulation and fetal development.
Purpose of the Study:
- To compare the levels of PC, PS, TM, and TAFI in maternal blood, cord blood, and amniotic fluid of healthy term pregnancies.
- To elucidate the distribution and potential roles of these coagulation factors during pregnancy and delivery.
Main Methods:
- Quantitative analysis of PC, PS, TM, and TAFI antigen concentrations using the immunoenzymatic method (ELISA).
- Study involved 136 healthy parturients at term, with samples collected from maternal plasma, cord blood plasma, and amniotic fluid.
Main Results:
- Protein C and Protein S concentrations were highest in maternal plasma, followed by cord blood plasma, and were lowest in amniotic fluid (p<0.0001).
- Thrombomodulin and TAFI concentrations were significantly higher in cord blood plasma compared to maternal plasma (p<0.0001).
- PC and PS levels decrease from mother to fetus to amniotic fluid, while TM and TAFI levels are highest in fetal circulation.
Conclusions:
- Maternal blood has the highest levels of PC and PS, essential for maintaining pregnancy homeostasis.
- Fetal circulation shows elevated levels of TM and TAFI, suggesting a distinct role in fetal hemostasis or adaptation.
- The differential distribution of protein C system components highlights their specific functions in maternal, fetal, and amniotic compartments during late pregnancy.
Abstract:
Activated protein C (APC) is an important anticoagulant which plays a role in pathophysiology of pregnancy, e.g. in maintenance of the uteroplacental circulation and development of the fetus as well as in pathogenesis of preeclampsia. The study objective was to compare the levels of the respective components of the protein C system (protein C, PC; protein S, PS; thrombomodulin, TM) as well as thrombin activatable fibrinolysis inhibitor - TAFI in mother's blood, cord blood and amniotic fluid. The study group consisted of 136 healthy parturients at term, divided into subgroups of 30-35. The immunoenzymatic method (ELISA) was used to measure the antigens of the components studied. The concentrations of PC and PS antigens were the highest in the mother's blood plasma (135.11+/-1.05% and 92.0+/-13.24%, respectively), lower in cord blood plasma (57.60+/-10.32% and 33.19+/-4.96%, respectively) and the lowest in amniotic fluid (6.75+/-3.50% and 2.40+/-1.64%, respectively); the differences between the levels of that of mother, fetus and amniotic fluid were statistically significant (p< or =0.0001). The TM and TAFI antigen concentrations were the highest in cord blood plasma (11.35+/-3.71 ng/ml and 91.50 (median; range: 71.76-160.77) ng/ml, respectively) and lower in maternal plasma (4.51+/-0.71 ng/ml and 55.46 - median; range: 39.77-68.54 ng/ml, respectively); the differences between the levels of that of cord blood plasma and maternal plasma were statistically significant (p< or =0.0001). Of the three protein C system components, PC and PS occur in relatively high concentrations in maternal blood, being lower in fetal blood and the lowest in amniotic fluid. On the other hand, as an exception, the concentrations of TM and TAFI are the highest in fetus blood.
