A rapid activated protein C sensitivity test as a diagnostic marker for a suspected venous thromboembolism in pregnancy and puerperium.
OBJECTIVE
The purpose of the study was to examine whether changes in response to activated protein C (APC) can be a diagnostic marker of venous thromboembolism (VTE) during pregnancy and puerperium.


METHODS
The normalized APC sensitivity ratio (sr) was examined in arbitrarily selected healthy Japanese pregnant females and compared with those in non-pregnant females and patients with VTE at the onset before anticoagulation in pregnancy and puerperium using an endogenous thrombin potential-based assay with a computer-assisted calibrated automated thrombography.


RESULTS
Sensitivity to APC in patients with VTE at onset was reduced in comparison to that in late pregnancy period and puerperium (p < 0.01, Student's t test). The odds ratio for VTE was 31.9 with statistical significance in pregnant females with suspected clinical symptoms and APC-sr (≥5), although the odds ratio for VTE was not significant with D-dimer (≥5).


CONCLUSIONS
These data suggest that an APC sensitivity test can be a possible surrogate diagnostic marker of suspected VTE during pregnancy and puerperium.
Department of Obstetrics and Gynecology, Hamamatsu University, School of Medicine, Hamamatsu, Japan.
Kyuya
K
Hirai
Motoi
M
Sugimura
Ryota
R
Ohashi
Kazunao
K
Suzuki
Hiroaki
H
Itoh
Kazuhiro
K
Sugihara
Naohiro
N
Kanayama
D020016:Activated Protein C Resistance; D000328:Adult; D015415:Biomarkers; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011486:Protein C / Q000494:pharmacology*; D011644:Puerperal Disorders / Q000175:diagnosis*; D013917:Thrombin / Q000032:analysis; D054556:Venous Thromboembolism / Q000175:diagnosis*
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; C036309:fibrin fragment D; D013917:Thrombin