Resistance to activated protein C and the Leiden mutation: High prevalencein patients with abruptio placentae

OBJECTIVE: The Leiden mutation, a point mutation in the gene encoding coagu lation factor V, is associated with a high frequency of thromboembolic phen omena. It has recently been connected with adverse outcomes of pregnancy. W e carried out this study to define its connection with abruptio placentae. STUDY DESIGN: Twenty-seven women who had abruptio placentae and 29 control subjects matched for age, parity, and ethnic origin were studied. We studie d all women for possible hypercoagulation defects. All women demonstrating resistance to activated protein C were studied for the presence of the fact or V Leiden mutation. RESULTS: Seventeen of 27 case patients had an activated protein C ratio les s than or equal to 2.5, compared with 5 of 29 control subjects (odds ratio 8.16, 95% confidence interval 3.6-12.75, P=.00125). Participants with activ ated protein C ratios less than or equal to 2.5 underwent deoxyribonucleic acid analysis. Eight case patients were found to have the factor V Leiden m utation (5 heterozygous and 3 homozygous, 29.6%), compared with 1 heterozyg ote among the control subjects who were tested (3.4%). CONCLUSION: Factor V Leiden mutation was found quite frequently in patients with abruptio placentae.