Evaluation of Protein C and Protein S in Pregnant Females with Preeclampsia
Iraqi Postgraduate Medical Journal,
2021, Volume 20, Issue 1, Pages 46-52
Preeclampsia (PE) is a multisystem progressive disorder characterized by the new onset of hypertension and proteinuria. Women with PE have been shown to be at increased risk of venous thromboembolism (VTE).
To evaluate the levels of protein C and protein S among females with PE, and todetermine whether there is relationship between deficiencies of these proteins and PE severity.
SUBJECTS AND METHODS:
A total of 30 pregnant women with PE and other 30 normotensive age-matched healthy pregnant women in their third trimester of pregnancy were enrolled in this case-control study. Beside blood pressure and general physical examination of each participant, peripheral venous blood sample were tested for complete blood count (CBC) prothrombin time (PT) activated partial thromboplastin time (APTT), protein C and protein S.
Out of 30 patients, there were 8 patients 26.67%) who had protein C deficiency compared to only 1 pregnant woman (3.33%) among the control group with a significant difference. Likewise, the frequency of protein S deficiency was 20% among patients, while none among controls had such deficiency. Mean plasma level of protein C and protein S in preeclmaptic women was 79.07±21.94% and 68.73±13.19%, respectively which was significantly lower than that of women with normal pregnancy (90.0± 14.96% and 78.67±10.17%, respectively). Furthermore, 50% of women suffering from protein C or protein S deficiency experienced severe PE while 95.45% and 91.67% of women with sufficient protein C and protein S, respectively displayed mild form of the disease.
Both protein C and protein S significantly reduced in pregnant women with PE and are associated with the severity of the disease.
- Sisti G, Colombi I. New blood pressure cut off for preeclampsia definition: 130/80 mmHg. Eur J Obst Gynecol Reprod Biol 2019;1:322-24.
- Hladunewich M, Karumanchi SA, Lafayette R. Pathophysiology of the clinical manifestations of preeclampsia. Clinical J Am Society Nephrol 2007;2:543-39.
- Smith CW, Beutler E, Lichtman M, Coller B, Kipps T. Williams hematology. Lichtman M, Kipps T, Seligsohn U, Kaushansky K, JT. P (eds). 2010.
- Hossain N, Shamsi T, Soomro N. Frequency of thrombophilia in patients with adverse pregnancy outcome. J Pak Med Assoc 2005;55:245.
- Onakewhor JU, Gharoro EP. Changing trends in maternal mortality in a developing country. Nigerian J Clin Prac 2008;11:111-20.
- Okoye HC, Eweputanna LI, Okpani AO, Ejele OA. Associations between pre‐eclampsia and protein C and protein S levels among pregnant Nigerian women. Int J Gynecol Obst 2017;137:26-30.
- Sooraj S. Prevalence of thrombophilia in patients with adverse pregnancy outcome. Int J Sci Study 2018;6:82-91.
- Philipp CS, Faiz AS, Beckman MG, Grant A, Bockenstedt PL, Heit JA, James AH, Kulkarni R, Manco-Johnson MJ, Moll S, Ortel TL. Differences in thrombotic risk factors in black and white women with adverse pregnancy outcome. Thrombosis Res 2014;133:108-11.
- Alfirevic Z, Roberts D, Martlew V. How strong is the association between maternal thrombophilia and adverse pregnancy outcome?: A systematic review. Eur J Obst Gynecol Reprod Biol 2002;101:6-14.
10. Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB. Increased frequency of genetic thrombophilia in women with complications of pregnancy. New Eng J Med 1999;340:9-13.
11. Walker MC, Garner PR, Keely EJ, Rock GA, Reis MD. Changes in activated protein C resistance during normal pregnancy. Am J Obst Gynecol 2002;177:162-69.
12. Demir C, Dilek I. Natural coagulation inhibitors and active protein c resistance in preeclampsia. Clinics 2010;65:1119-22.
13. Yalinkaya A, Erdemoglu M, Akdeniz N, Kale A, Kale E. The relationship between thrombophilic mutations and preeclampsia: a prospective case-control study. Ann Saudi Med 2006;26:105-9.
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