Effects of anticoagulation protein defect in maternal plasma on spontaneous abortion.
OBJECTIVE
To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage.


METHODS
Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombin III (AT-III), as well as activated protein C resistance (APC-R). The control group consisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for, measuring serum activity of protein C, protein S, AT-III, and APC-R. Patients with positive APC-R were tested for factor V (FV) Leiden gene mutation by PCR-RFLP method.


RESULTS
Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-III deficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-III deficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FV Leiden gene mutation was identified in all the patients with positive APC-R results. Late spontaneous abortion cases had higher incidence of anticoagulation protein defect than the early cases.


CONCLUSIONS
Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurring in late stage of pregnancy.
Bai
Chun-mei
CM
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730. chunmeib2000@yahoo.com
Ma
Shui-qing
SQ
Gai
Ming-ying
MY
Fan
Lian-kai
LK
Ren
Feng-yan
FY
Fan
Guang-sheng
GS
D000026:Abortion, Habitual / Q000097:blood / Q000209:etiology*; D020016:Activated Protein C Resistance / Q000097:blood / Q000150:complications* / Q000235:genetics; D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D020152:Antithrombin III Deficiency / Q000097:blood / Q000150:complications*; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D017354:Point Mutation; D011486:Protein C / Q000378:metabolism; D020151:Protein C Deficiency / Q000097:blood / Q000150:complications*; D017293:Protein S / Q000378:metabolism; D018455:Protein S Deficiency / Q000097:blood / Q000150:complications*
D011486:Protein C; D017293:Protein S; C095381:factor V Leiden; D000990:Antithrombin III; D005165:Factor V