Unfavourable pregnancy outcome associated with congenital protein C deficiency: Case reports

Article Abstract:

Protein C is a blood protein that is converted to protein Ca, which prevents the coagulation of blood. An inherited deficiency of protein C results in thrombosis, the formation of blood clots. Protein C deficiency in pregnancy may be complicated by impaired blood flow within the uterus and placenta, the tissue that provides the fetus with nutrients during pregnancy. This may lead to intrauterine growth retardation (of the fetus); pre- eclampsia, a disorder characterized by increasing hypertension, headaches, urinary excretion of the blood protein albumin, and edema in the legs and feet; abruptio placentae (also known as placental abruption), or premature separation of the placenta; and fetal death. Protein C deficiency in pregnancy is also associated with placental ischemia, or an insufficient blood supply to the placenta, and placental infarction, or placental tissue death due to cessation of blood supply. A case is described of a 36-year-old woman with a previous miscarriage, a normal second pregnancy, and a third pregnancy complicated by severe fetal growth retardation. The patient was diagnosed with protein C deficiency. During her fourth pregnancy, she was treated with the anticoagulant heparin, which prevents blood coagulation, from the 16th week of pregnancy until after childbirth. She gave birth to a healthy male infant at 39 weeks of pregnancy. The second case is a 24-year-old woman who developed abruptio placentae in her first pregnancy, resulting in premature delivery by cesarean section and death of the newborn. The patient also had convulsions, brain lesions, and a blood clot in a calf vein, which was treated with heparin. The convulsions recurred in the first three months of her second pregnancy, and the she was treated with heparin from 32 weeks of pregnancy until after childbirth. The patient gave birth to a healthy infant at 38 weeks of pregnancy, and was later diagnosed with protein C deficiency. Thus, anticoagulants are effective in preventing complications due to thrombosis during pregnancy and following childbirth. The relation between protein C deficiency and placental ischemia requires further study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Complications and side effects, Pregnancy, Complications of, Pregnancy complications, Thrombosis, Protein C deficiency

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Effect of nifedipine on fetal and maternal hemodynamics and blood gases in the pregnant ewe

Article Abstract:

Nifedipine infusion to pregnant sheep may cause deterioration of fetal blood gases out of proportion to placental blood flow. Nifedipine is used to suppress uterine contractions and to treat hypertension in pregnancy. Researchers infused 10 pregnant sheep with nifedipine or placebo solution. Changes in placental blood flow were minor while fetal blood flow was elevated with high doses of nifedipine. Lactate levels increased in both mothers and fetuses. Fetuses experienced lack of oxygen and drops in blood acid content which continued after nifedipine infusion ended. The cause of the change in blood gases is unknown.

Maternal-fetal exchange, Hemodynamics, Blood gases, Nifedipine

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