Precursor prothrombin status in two mother-infant pairs following gestational anticonvulsant therapy.
Protein in vitamin K absence (PIVKA) is the prothrombin precursor found in plasma when carboxylation to prothrombin is impaired. We report on two cases in which mother-infant PIVKA concentrations were measured at birth after chronic anticonvulsant therapy during pregnancy. Maternal values were 2.4 and 4%, and infant values 20.0 and 18% in cases 1 and 2, respectively. This demonstrates that, despite the normal coagulation profiles previously described, mothers on chronic anticonvulsant therapy may have a subclinical carboxylation defect, while their infants are at risk for hemorrhagic disease. Estimation of maternal PIVKA levels may be of value for predicting risk of hemorrhage in the neonate.
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D015415:Biomarkers; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005312:Fetal Blood / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000188:drug therapy; D011379:Prognosis; D011498:Protein Precursors / Q000032:analysis*; D011516:Prothrombin / Q000032:analysis*; D006475:Vitamin K Deficiency Bleeding / Q000097:blood / Q000209:etiology
D000927:Anticonvulsants; D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin