Resistance to Activated Protein C and Deep Venous
Thrombosis during Pregnancy
Procházka M.1, Krčová V.2, Hrachovec P.1, Kudela M.1, Slavík L.2
1Porodnicko-gynekologická klinika FN a LF UP Olomouc, přednosta prof. MUDr. M. Kudela, CSc. 2Hematoonkologická klinika FN a LF UP Olomouc, přednosta prof. MUDr. K. Indrák, DrSc. |
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Summary:
Objective: The aim of the study was to detect the incidence of resistance to activated protein C in
pregnant or puerperal women with confirmed diagnosis of deep venous thrombosis or pulmonary
embolism.
Design: Case-control study.
Setting: Dept. of Obstetrics and Gynaecology, Dept. of Haemato-oncology, Medical Faculty, Palacký
University, Olomouc.
Methods: The group of 33 women with confirmed deep venous thrombosis were examined for
resistance to activated C protein. The levels of C and S proteins, antithrombin III., prothrombin,
heparin II cofactor and plasminogen were measured. Patient with APC ratio below 1.86, were
tested by PCR analysis for the detection of the FV:Q506 allele.
The control group had 51 pregnant women, chosen randomly. The statistical evaluation was
performed by STATISTICA program. For the analyzing of the continuous variables the Students’
T-test was used. For the categorical variables the 2 test was used (for comparison of 2 relative
values). Values below P<0.01 were considered to be statistically significant.
Results: Women who have shown to suffer from deep venous thrombosis (DVT) came to the mean
age of 31 ± 3.1 years, weight 75.3 ± 7.9 kg and BMI 28.7 ± 4.3. All of the results above were
rendered to be statistically significant. 54.5% of thrombosis occured in the 3rd trimester, 61% were
localised to the left iliofemoral vein. APC resistance appeared in 17 (51%) women with DVT, in
comparison to 5 (9.8%) women in the control group (i.e. statistically significant). Factor V appeared
in II (33.3%) women, in comparison to 3 (5.9%) women in the control group.
Conclusion: APC resistance and factor V. Leiden represent as important factors in the aetiology of
deep venous thrombosis in pregnancy.
Key words:
thrombosis, pregnancy, thrombophilia
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