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Changes in activated protein C resistance during normal pregnancy
M C Walker1, P R Garner, E J Keely
1Department of Obstetrics and Gynecology, University of Ottawa, Ontario, Canada.
American Journal of Obstetrics and Gynecology
|July 1, 1997
Summary
Activated protein C resistance increases during pregnancy, particularly in the second and third trimesters. This change is linked to alterations in other coagulation factors, a normal physiological event.
Area of Science:
- Coagulation science
- Reproductive medicine
- Thrombosis research
Background:
- Pregnancy involves significant physiological changes in the hemostatic system.
- Understanding alterations in coagulation is crucial for managing pregnancy-related risks.
Purpose of the Study:
- To investigate changes in activated protein C (APC) resistance during normal pregnancy.
- To correlate APC resistance with other coagulation factors and the Factor V Leiden mutation.
Main Methods:
- Cross-sectional study of 128 pregnant women across trimesters and nonpregnant controls.
- Measurement of APC, Factor V, Factor VIII, free Protein S, and functional Protein C.
- Polymerase chain reaction for Factor V Leiden mutation detection.
Main Results:
- A significant decrease in APC activity was observed in the second and third trimesters (p < 0.05).
- This reduction correlated with elevated Factor VIII and reduced free Protein S levels (p = 0.002).
- Factor V Leiden mutation prevalence was 7.3%.
Conclusions:
- Pregnancy, especially in later trimesters, is associated with increased resistance to activated protein C.
- These changes are attributed to normal pregnancy-induced alterations in coagulation proteins.
- The findings highlight physiological hemostatic adaptations during gestation.