Evaluation of gamma-glutamyl carboxylase level and bleeding tendency among pregnant women attending Federal Medical Centre Katsina

Abstract

Background: Postpartum haemorrhage contributes significantly to maternal mortality and morbidity in Nigeria and globally with retained placenta being identified as the leading cause in Nigeria.

Aim: This study was designed to establish the relationship between gamma-glutamyl carboxylase (GGCX) levels and bleeding tendencies among pregnant women.

Methodology: The study was conducted at Federal Medical Centre (FMC) in Katsina, Nigeria. A total number of 180 subjects were sampled after obtaining  their informed consent. The ELIZA method was used to analyze the gamma-glutamyl carboxylase enzyme while a semi-automated  coagulometer was used to analyze the prothrombin time (PT) and activated partial thromboplastin time (APTT).

Results: The results obtained were analyzed using SPSS version 20. The mean ages of the participants were 27±5.13years and about nineteen (10.6%)  were in the first trimester of their pregnancy, ninety-one (50.6%) in the second trimester, and seventy (38.9%) were in the third trimester. At the end of the  study, it was established that, at P< 0.05 level of significance, there is a weak positive correlation and no linear relationship (r = 0.06, n = 180, P =  0.935) between gamma-glutamyl carboxylase (GGCX) and prothrombin time (PT) and a negative correlation and no linear relationship (r = −0.093, n = 180,  P = 0.212) between gamma-glutamyl carboxylase (GGCX) and activated partial thromboplastin time (APTT). About eighty-three (46.1%) of the  subjects sampled showed a high risk of bleeding with a prothrombin time >15 seconds and about twenty-three (12.8%) showed a high risk of bleeding  with an APTT >37 seconds and none of the subjects showed an absolute deficiency of gamma-glutamyl carboxylase enzyme.

Conclusion: The assessment  of gamma-glutamyl carboxylase and prothrombin time might be very useful in identifying patients at risk of postpartum  bleeding and thereby reducing the incidents of maternal mortality and morbidity due to postpartum haemorrhage.