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Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study

  • Mieczysław Uszyński , Ewa Żekanowska , Marcin Kotzbach , Waldemar Uszyński and Roman Kotzbach
Published/Copyright: July 19, 2006
Journal of Perinatal Medicine
From the journal Volume 34 Issue 4

Abstract

Objectives: The main components of protein C anticoagulant system are protein C (PC), protein S (PS) and thrombomodulin (TM); the system plays a protective role in pregnancy, mainly because it prevents the utero–placental circulation from local thrombosis. It is unknown whether the protein C anticoagulant pathway exists in amniotic fluid. The aim of the present study is to find out whether these three components are present in amniotic fluid.

Study design: The study group consisted of 50 parturients with an uneventful pregnancy and birth and 25 non-pregnant controls. Amniotic fluid and blood were sampled at the end of the 1st stage of labor. PC, PS and TM were measured by immunoenzymatic method.

Results: All the samples of amniotic fluid contained measurable amounts of antigens of PC, PS and TM, although their concentrations were significantly lower than in the mother's blood: (i) The concentration of PC in amniotic fluid was 6.24±3.50% and PS 2.40±1.64%, while in the mothers' plasma it was 138.26±12.38% and 93.15±13.24%, respectively (P<0.0001). (ii) TM con-centration in amniotic fluid constituted 63.92% of the concentration in the mother's blood (2.71±1.21 ng/mL vs. 4.24±0.88 ng/mL, P<0.001).

Conclusion: Protein C, protein S and thrombomodulin are physiological constituents of the amniotic fluid. As their concentrations are low, it is reasonable to assume that they cannot counterbalance the procoagulant activity of amniotic fluid.

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Corresponding author: Prof. Mieczysław Uszyński Department of Propedeutics of Medicine, Nicolaus Copernicus University, Toruń, Collegium Medicum, Bydgoszcz, ul. Świętojańska 20 85-077 Bydgoszcz Poland Tel./fax: (052) 585 10 11 Fax: (48 52) 585 3308

References

1 Boffa M-C, L Valsecchi, A Fausto, D Gozin, KS D'Angelo, O Safa, et al.: Predictive value of plasma thrombomodulin in preeclampsia and gestational hypertension. Thromb Haemost79 (1998) 1092Search in Google Scholar

2 Clark P, A Greer, D Walker: Interaction of the protein C/protein S anticoagulant system, the endothelium and pregnancy. Blood Rev15 (1999) 127Search in Google Scholar

3 Esmon Ch: The endothelial cell protein C receptor. Thromb Haemost83 (2000) 63910.1055/s-0037-1613883Search in Google Scholar

4 Faught W, P Garner, G Jones, B Ivey: Changes in protein C and protein S levels in normal pregnancy. Am J Obstet Gynecol172 (1995) 147Search in Google Scholar

5 Fazel A, A Vincenot, A Malassine, et al.: Increase in expression and activity of thrombomodulin in term human placenta syncytiotrophoblast microvilli. Placenta19 (1998) 261Search in Google Scholar

6 Isermann B, SB Hendricson, K Hutley, M Wing, H Weiler: Tissue-restricted expression of thrombomodulin in the placenta rescues thrombomodulin-deficient mice from early lethality and reveals a secondary developmental block. Development128 (2001) 850Search in Google Scholar

7 Kupferminc MJ, M Eldor, N Steinman: Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med340 (1999) 9Search in Google Scholar

8 Lanir N, A Aharon, B Brenner: Procoagulant and anticoagulant mechanisms in human placenta. Semin Thromb Heamost29 (2003) 175Search in Google Scholar

9 Lockwood ChJ, R Bach, A Guha, et al.: Amniotic fluid contains tissue factor, a potent initiator of coagulation. Am J Obstet Gynecol165 (1991) 1335Search in Google Scholar

10 de Moerloose P, N Mermillod, J Amiral, G Reber: Thrombomodulin levels during normal pregnancy, at delivery and in the postpartum: comparison with tissue-type plasminogen activator and plasminogen activator inhibitor-1. Thromb Haemost79 (1998) 554Search in Google Scholar

11 Moniwa N: Relationship of urokinase type plasminogen activator, plasminogen activator inhibitor type 1 and activated protein C in fibrinolysis of human placenta. Pol J Pharmacol48 (1996) 215Search in Google Scholar

12 Mousa HA, C Doweney, Z Alfirevic, Ch-H Toh: Thrombin activatable fibrinolysis inhibitor and its fibrinolytic effect in normal pregnancy. Thromb Haemost92 (2004) 1025Search in Google Scholar

13 Thompson AR: Factor IX and prothrombin in amniotic fluid and fetal plasma: constraints on prenatal diagnosis of hemofilia B and evidence of proteolysis. Blood64 (1984) 86710.1182/blood.V64.4.867.867Search in Google Scholar

14 Queenan J, E Gadow, P Bachner, S Kubarych: A proteins in normal and RH-sensitized pregnancies. Am J Obstet Gynecol108 (1970) 406Search in Google Scholar

15 Takahashi H, S Ito, M Hanano, et al.: Circulating thrombomodulin as a novel endothelial cell marker: comparison of its behavior with von Willebrand factor and tissue-type plasminogen activator. Am J Hematol41 (1992) 32Search in Google Scholar

16 Uszyński M, W Uszyński, A Kiełkowski: Tissue plasminogen activator and plasminogen activator inhibitors of types 1 and 2 in amniotic fluid before labor and childbirth. Gynecol Obstet Invest39 (1995) 93Search in Google Scholar

17 Uszyński M, A Kiełkowski, W Uszyński, E Żekanowska: Thrombin- antithrombin III complexes and antithrombin III in amniotic fluid. Gynecol Obstet Invest43 (1997) 29Search in Google Scholar

18 Uszyński M, A Kłyszejko, E Żekanowska: Plasminogen, alfa-2-antiplasmin and complexes of plasmin-alfa 2-antiplasmin (PAP) in amniotic fluid and blood plasma of parturient women. Eur J Obstet Gynecol Rep Biol93 (2000) 167Search in Google Scholar

19 Uszyński M, E Żekanowska, W Uszyński, J Kuczyński: Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in amniotic fluid and blood plasma: implicatios for the mechanism of amniotic fluid embolism. Eur J Obstet Gynecol Rep Biol95 (2001) 163Search in Google Scholar

20 Walker MC, PR Garner, EJ Keely, GA Rock, MD Reis: Changes in activated protein C resistance during normal pregnancy. Am J Obstet Gynecol177 (1997) 162Search in Google Scholar

Published Online: 2006-07-19
Published in Print: 2006-08-01

©2006 by Walter de Gruyter Berlin New York

Articles in the same Issue

  1. Advances in Perinatal Medicine - 5th Annual meeting of the Italian Society of Perinatal Medicine held in Parma, Italy on June 15th – 17th 2006
  2. Hemorrhagic shock in obstetrics
  3. Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR
  4. Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
  5. Accuracy and influence of ascorbic acid on glucose-test with urine dip sticks in prenatal care
  6. Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
  7. Timing of cord clamping revisited
  8. Intrapartum cardiotocography – the dilemma of interpretational variation
  9. Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
  10. Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
  11. Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
  12. Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
  13. Outcome of fetuses in women with pregestational diabetes mellitus
  14. Outcome of fetuses in women with pregestational diabetes mellitus
  15. Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
  16. To drain or not to drain: a single institution experience with neonatal intestinal perforation
  17. Infective puerperal endocarditis caused by Escherichia coli
  18. Correlation between plasma and urinary caffeine levels in preterm infants
  19. Fetal ascites secondary to urinary hydrocolpos
  20. Congress Calendar
  21. Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor
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