CHANGES OF RESISTANCE TO ACTIVATED PROTEIN-C IN THE COURSE OF PREGNANCY AND PREVALENCE OF FACTOR-V MUTATION

The purpose of this study was to examine the changes in activated prot ein C (APC) anticoagulant activity during pregnancy and determine whet her changes in APC could contribute to thrombosis in the placental bed in preeclampsia. We measured APC anticoagulant activity in 150 women with a normal pregnancy and 50 women with preeclampsia. There was a si gnificant reduction in the mean APC sensitivity ratio (APC-SR) during pregnancy (p<0.001). APC resistance in preeclampsia was significantly higher than in normal pregnancy (p<0.01). Amongst women with APC resis tance the presence of the factor V Leiden mutation was significantly h igher in the preeclampsia group than in the normal pregnancy group (p< 0.01). It seems that both factor V Leiden mutation and APC resistance may be associated with the development of preeclampsia. These results suggest that APC resistance may be an important mechanism underlying p lacental bed pathology in pregnancy and may be associated with an incr eased tendency to develop preeclampsia in some women. Assay of APC res istance and factor V Leiden mutation should be performed in women with preeclampsia.