Deficiency of Protein C and Protein S in Recurrent Pregnancy Loss

Naji Alshammary, Hussein; M.A. Almosawi, Hadi; Salih Hadi, Farah

	Deficiency of Protein C and Protein S in Recurrent Pregnancy Loss
Medical Journal of Babylon
Article 1, Volume 12, Issue 2, 2015, Pages 348-356
Authors
Hussein Naji Alshammary; Hadi M.A. Almosawi; Farah Salih Hadi
Abstract
Recurrent pregnancy loss (RPL) is a common disorder that affects around 3-5% of pregnant women. It has different causes and in about 50% it is of unknown etiology. Normal pregnancy is associated with increased procoagulants, decreased fibrinolysis and decreased anticoagulants to maintain placental hemostasis during pregnancy. However, hypercoagulability or thrombophilia might be a risk factor with these changes especially in women with deficiency of any of natural anticoagulant factors. Protein C and protein S are natural anticoagulants and their deficiency was found to be associated with placental thrombosis, hypo perfusion, fetal death and fetal loss. The aim of the study is to identify protein C and protein S deficiency in women with recurrent pregnancy loss. 90 women were involved in the study, 45 of them have three or more miscarriages in the first and second trimester considered as patient group, 45 healthy women at time of full term delivery with at least one alive child as control group. Full history was taken from patients and controls. Blood investigations were done for protein C and protein S levels by using ELISA (enzyme linked immune sorbent assay).Platelets count was performed by auto analyzer (Ruby). The results showed a significant relation of low protein S with recurrent miscarriage (P =0.002) OR=2.250 (95%C.I. 1.764-2.870), while the relation of low protein C with recurrent miscarriage was not significant (P>0.05).There was a significant association of low protein S andlow protein C with the abortion occurred in the second trimester (P<0.05). Positive family history for thrombosis was significantly associated with recurrent abortion (p<0.05). Platelets count has non-significant association with recurrent miscarriage. There is a significant association of protein S deficiency with recurrent miscarriage especially in the miscarriages occurring in the second trimester.Thepositive family history of thrombosis is considereda risk factorfor recurrentmiscarriage.Protein C deficiency had no statistical significant.
Keywords
protein C; protein S; recurrent pregnancy loss

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