Kalmegh Sai, Patvekar Meenal
Obstetrics and Gynecology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Pune, IND.
Cureus. 2024 Jul 10;16(7):e64289. doi: 10.7759/cureus.64289. eCollection 2024 Jul.
This case report details a 30-year-old pregnant woman with inherited protein C deficiency who developed severe preeclampsia (PE), intrauterine growth restriction, and pancytopenia. Despite treatment, including anticoagulants, her condition worsened, resulting in postpartum mortality. Protein C deficiency, integral to the coagulation cascade, can exacerbate pregnancy's hypercoagulable state, contributing to adverse outcomes like PE. Mutations in the protein C gene can cause type I or type II deficiency, affecting protein C antigen and activity levels. The patient's history of recurrent pregnancy losses and conception via in vitro fertilization despite advisories highlights the complexities of managing pregnancy complications with protein C deficiency. Although some studies do not establish a direct link between protein C levels and PE, further research should explore thrombophilia's role in PE development and recurrence. Prospective studies investigating antithrombotic strategies in thrombophilic pregnancies could offer insights into reducing PE recurrence risks. This case underscores the need for multidisciplinary management and ongoing research to enhance clinical strategies and outcomes in high-risk pregnancies involving protein C deficiency.
本病例报告详细介绍了一名30岁患有遗传性蛋白C缺乏症的孕妇,她出现了重度子痫前期(PE)、胎儿生长受限和全血细胞减少症。尽管接受了包括抗凝剂在内的治疗,她的病情仍恶化,最终导致产后死亡。蛋白C是凝血级联反应不可或缺的一部分,其缺乏会加剧妊娠的高凝状态,导致如子痫前期等不良后果。蛋白C基因的突变可导致I型或II型缺乏,影响蛋白C抗原和活性水平。尽管有建议,该患者仍有反复流产史且通过体外受精受孕,这凸显了管理蛋白C缺乏症妊娠并发症的复杂性。虽然一些研究未确立蛋白C水平与子痫前期之间的直接联系,但进一步研究应探讨血栓形成倾向在子痫前期发生和复发中的作用。调查血栓形成倾向妊娠抗栓策略的前瞻性研究可为降低子痫前期复发风险提供见解。本病例强调了多学科管理和持续研究的必要性,以改善涉及蛋白C缺乏症的高危妊娠的临床策略和结局。