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Human Reproduction, Vol. 14, No. 12, 3112-3115, December 1999
© 1999 European Society of Human Reproduction and Embryology

Activated protein C resistance shows an association with pregnancy-induced hypertension

B.S. Horstkamp1,3, H. Kiess1, J. Krämer2, H. Riess2, W. Henrich1 and J.W. Dudenhausen1

1 Department of Obstetrics and 2 Department of Internal Medicine, Medical Faculty Charité, Campus Virchow-Klinikum and Campus Berlin-Buch, Humboldt University of Berlin, Augustenburger Platz 1, 13353 Berlin, Germany

A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women. In 70 women with a history of severe PIH, of whom 15 had pre-eclampsia, we investigated common coagulation factors as well as APC resistance (factor V related). We found that seven of these 70 women showed low values for APC. Out of these, five were heterozygous and none was homozygous for factor V Leiden mutation. In a control group of normotensive pregnant women we found a 3.0% rate of APC resistance and a 3.0% rate of carriers of the Leiden mutation. These results indicate a significantly higher prevalence of both APC resistance and factor V Leiden mutation in women with severe PIH. Placental infarctions and micro-embolisms are considered to be one of the principle pathophysiological changes in severe PIH. Our results suggest that APC resistance is a risk factor for severe PIH, in addition to its well-known role in macrothrombo-embolism.

Key words: APC resistance/factor V Leiden mutation/placental infarction/pre-eclampsia/pregnancy-induced hypertension

3 To whom correspondence should be addressed


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