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Protein C deficiency and pregnancy: a case report
J J Vogel1, P A de Moerloose, H Bounameaux
1Hemostasis Unit, University Hospital of Geneva, Switzerland.
Insights
Women with severe protein C deficiency face high risks of blood clots during pregnancy. Ambulatory heparin therapy during pregnancy can ensure successful outcomes, but more research is needed for definitive guidelines.
Area of Science:
- Hematology
- Reproductive Medicine
- Thrombosis Research
Background:
- Protein C deficiency significantly elevates thromboembolism risk, particularly in pregnant women.
- Pregnancy and delivery amplify the risk of life-threatening thromboembolic complications in protein C-deficient individuals.
- The incidence of thromboembolic events in protein C-deficient women is exceptionally high compared to the general population.
Observation:
- A case report of a 26-year-old woman with severe congenital protein C deficiency (25% antigen and activity) and a history of iliofemoral deep vein thrombosis.
- The patient successfully completed pregnancy and delivery.
- Anticoagulation was managed with heparin during the latter half of her pregnancy.
Findings:
- Successful pregnancy and delivery were achieved in a patient with severe protein C deficiency.
- Ambulatory, full-dose subcutaneous heparin therapy during pregnancy was effective in preventing thromboembolic events.
- This case suggests the potential efficacy of heparin anticoagulation in managing high-risk pregnancies.
Implications:
- Ambulatory full-dose subcutaneous heparin may be an adequate preventive strategy for thromboembolism during pregnancy in protein C-deficient women.
- Further extensive studies are required to establish definitive clinical guidelines for managing protein C deficiency during pregnancy.
- This case highlights the importance of individualized anticoagulation management in high-risk pregnancies.
Abstract:
Protein C is thought to play a key role in the regulation of hemostasis, and its deficiency has been associated with an increased risk of thromboembolism. Protein C-deficient women are at particular risk of developing thromboembolic complications during pregnancy and delivery. The incidence of thromboembolic events is estimated to be 500-1000 times higher than in normal women. We report the case of a 26-year-old woman with previous iliofemoral deep vein thrombosis who experienced a successful pregnancy and delivery despite severe congenital protein C deficiency (protein C antigen and activity 25%). She was anticoagulated with heparin during the second part of her pregnancy. Our observation suggests that ambulatory full-dose subcutaneous heparin therapy during pregnancy constitutes adequate prevention. However, definite guidelines will require more extensive studies.