ACTIVATED PROTEIN C RESISTANCE AS A RISK FACTOR FOR PREECLAMPSIA

Abstract

Preeclampsia is a major cause of maternal and perinatal mortality and morbidity worldwide, particularly in developing countries explaining why the need for its accurate prediction is held to be one of the main priorities in modern obstetrical practice. Numerous tests have been proposed for prediction of PE. Unfortunately, most of these tests suffer

• from poor sensitivity and positive predictive value, and the majority of them are not suitable for routine use in clinical practice. ■ There is activation of coagulation system in PE. It was found that

coagulation related pathologic features constitute > 30% of the pathophysiologic background in PE. Placental infarction is considered to be one of the principal pathologic changes in PE. Recently, a hereditary abnormality has been identified in the protein C anticoagulant pathway called APC resistance which is usually caused by mutation in factor V gene called Leiden mutation. The molecular basis for APC resistance in most patients is a point mutation at nucleotide position 1691 of the factor V gene, that result in substitution of glutamine for arginine at position 506 in factor V molecule. Recent studies reported that PE is associated with APC resistance and factor V Leiden mutation.