Interaction of the protein C/protein S anticoagulant system, the endothelium and pregnancy. |
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Authors: | P Clark I A Greer I D Walker |
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Affiliation: | Department of Haematology, Royal Infirmary, Glasgow, UK. pc@glenisla.demon.co.uk |
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Abstract: | Normal pregnancy is associated with significant changes in haemostasis, lipid metabolism and endothelial function. This suggests that maternal adaptation in these systems is required for successful pregnancy outcome. A number of acquired and heritable prothrombotic abnormalities are associated with complications in pregnancy. A common feature of these abnormalities is their ability to alter endothelial function or the protein C/protein S system and increase thrombin generation. In this review the normal function of the endothelium and the protein C/protein S system is detailed. The changes which characterize normal and complicated pregnancies are outlined and the evidence for the impact of heritable and acquired disorders of the protein C/protein S system on pre-eclampsia and fetal loss are discussed. |
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