APC resistance can lead to abortion in women

Activated protein C (APC) resistance is a condition that causes the blood to clot more easily. This is because the body’s natural anticoagulant system is malfunctioning. APC is a protein that aids in the breakdown of blood clots. Blood clots can form more easily when it is not functioning properly.

Five to eight percent of the population has APC resistance, which is the most common risk factor for venous thrombosis and pulmonary embolism that can be found in a lab. This can also make women more likely to have an abortion.

Factor V Leiden variant is a genetic change in the gene responsible for coagulation factor V, which changes factor V and its binding sites for activated protein C (APC). APC is an inhibitor of blood clotting.

Resistance to APC increases the tendency to clot, which is a risk factor for thrombosis. Other risk factors such as immobility, prolonged sitting, smoking, and the pill are also decisive.

Thrombosis is three to four times more likely to happen to people who have the changed gene on one of their chromosomes. People with the changed gene on both sets of chromosomes are 60–80 times more likely to get thrombosis. Swedish doctor Bjorn Dahlbeck found out about APC resistance. Factor V Leiden variant was named after the Dutch city of Leiden, where the genetic flaw was found.

 how is factor V Leiden variant and APC resistance identified?

The doctor will recommend testing for possible APC resistance, especially if

  • thromboses occur without any external cause
  • younger patients have a thrombosis
  • Thrombosis often occurs within the family
  • Thrombosis occurs in unusual places
  • spontaneous abortion occurred

APC resistance and the Factor V Leiden variant: how are they managed?

There is no cure for Factor V Leiden variant. However, risk factors that favor the development of thrombosis can be minimized.

This includes the following measures: 

Smoking should be prohibited. The use of birth control pills is linked to an increased risk of thrombosis. The benefits and risks should be carefully balanced. 

Thrombosis prophylaxis with compression stockings is recommended in high-risk situations such as long-haul flights, and additional prevention (prophylaxis) with heparin injections into the subcutaneous tissue to thin the blood is also possible. In the case of spontaneous or recurrent thrombosis, the doctor may also recommend long-term anticoagulant therapy.

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Author: DoctorMaryam.org

4th Professional Medical Student. Karachi Medical and Dental College.

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