Vaskulárna medicína 2/2022

Abstract: Protein S deficiency in pregnancy – introduction and own experience

Introduction: Protein S (PS) deficiency is one of the most important changes in haemostasis that might arise during pregnancy. Methods and patients: In this prospective longitudinal study, we analyzed the parameters of special haemostasis measured four times during of pregnancy and once after the postpartum period. Results: We showed that despite the targeted and individualized thromboprophylaxis with the use of LMWH, PS deficiency did not normalize even after the postpartum period. Similarly, in this interval we did not observed the normalization of the results of FVIII and ProC Global test indicating persistence of the resistance to the activated protein C (APCR). We changed the dose of LMWH on the basis of these results, as well as according to the status and weight of the patients. Conclusion: Based on the obtained data, there is a question whether the removal of antithrombotic prophylaxis after the postpartum period due to the persistence of some of the prothrombotic changes of hemostasis is safe.

Keywords: protein S deficiency, low molecular weight heparin, at-risk pregnancy