Increased Prevalence of Activated Protein C Resistance During Pregnancy may Implicate Venous Thrombo Embolic Disorders as a Common Cause of Maternal Mortality in Nigeria

Abstract

Background: Acquired resistance to protein C in pregnancy has been established as one of the factors associated with thromboembolic phenomenon, an important cause of maternal mortality and morbidity.

Objectives: To establish the mean levels of PCA ratio (measure of protein C resistance) of among our pregnant women since maternal mortality rate of the country is on the increase despite efforts to reduce this trend.

Materials and Methods: A prospective study was carried out in a tertiary institution in Enugu State, Southeastern Nigeria over the 7 months period from May 2010 to November 2010. Two hundred pregnant women and 50 non pregnant female controls were recruited and PCA ratio, (coagulometric assay) were determined. 

Results: There was a non significant difference between the mean and standard deviation PCA ratio of the female non pregnant controls and pregnant women in 2nd trimester 4.32±0.4 and 4.30±0.4 respectively. A significant difference was noted between the controls and pregnant women in 3rd trimester 4.32±0.4 and 3.87±0.5 respectively also between the pregnant women in their 2nd and 3rd trimester 4.30±0.4 and 3.87±0.5 respectively.

Conclusion: There is increased protein resistance C in our pregnant women. This may implicate thromboembolic disorders as one of the leading causes of increase maternal mortality despite a downward trend in the prevalence of post partum haemorrhage.

Keywords: Acquired protein C resistance, maternal mortality, pregnancy, post partum hemorrhage, thromboembolic disorders