October 2021 · Volume 10 · Issue 10 Page 3715
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Musa AU et al. Int J Reprod Contracept Obstet Gynecol. 2021 Oct;10(10):3715-3724
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Clinical correlates of plasma antithrombin and protein C levels in
patients with pre-eclampsia and eclampsia in Sokoto, Northwest Nigeria
Abubakar U. Musa
1
*, Aisha I. Mamman
2
, Abubakar A. Panti
3
,
Abdul Wahab Alhassan
4
, Anas F. Rabiu
3
INTRODUCTION
Hypertensive disorders of pregnancy complicate about
10% of pregnancies worldwide and comprise of diseases
such as pre-eclampsia, eclampsia, gestational hypertension
and chronic hypertension.
1,2
Pre-eclampsia and eclampsia
stand out among the hypertensive disorders of pregnancy
for their impact on maternal and neonatal health
DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20213834
1
Department of Haematology and Blood Transfusion, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
2
Department of Haematology and Blood Transfusion, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna,
Nigeria
3
Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
4
Department of Human Physiology, College of Medical Sciences, Ahmadu Bello University Zaria, Kaduna, Nigeria
Received: 06 August 2021
Accepted: 03 September 2021
*Correspondence:
Dr. Abubakar U. Musa,
E-mail: abubakarumar38@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Hypertensive disorders of pregnancy complicate 17% of pregnancies in Sokoto, Nigeria with pre-
eclampsia and eclampsia accounting for 6% and 4.29% respectively. Pre-eclampsia and eclampsia stand out as major
causes of poor pregnancy outcomes with eclampsia contributing 46% of adolescent maternal mortality in Sokoto. These
disorders increase risk of venous thromboembolism, DIC, placental abruption, IUGR, premature delivery and recurrent
pregnancy loss. The roles of antithrombin and protein C in disease severity and outcomes of pregnancies in pre-
eclampsia/eclampsia are subject of recent researches albeit with conflicting findings. The aim of the study was to
determine the plasma antithrombin and protein C levels of pre-eclampsia and eclampsia in Sokoto with a view to
assessing any relationship with clinical severity and pregnancy outcomes.
Methods: Prospective comparative study involving 31 each of pregnant women with pre-eclampsia, eclampsia and
normotensive pregnancy. Plasma antithrombin and protein C levels were determined via kinetic method using S4 Nortek
semi-automated coagulometer. Data analysis was performed using SPSS version 21.0.
Results: The mean plasma antithrombin and protein C levels for eclampsia, pre-eclampsia and normotensive pregnancy
were (61.17±9.13 and 60.00±5.76) vs (71.24±13.15 and 71.06±6.16) vs (85.54±8.77 and 89.64±7.61) respectively;
p=0.0001. Severe pre-eclampsia when compared with mild pre-eclampsia had lower antithrombin (70.21±13.58 vs
73.74±12.43; p=0.507) and protein C (70.52±6.27 vs 72.40±6.00; p=0.451) levels respectively, though without
statistical significance. Pre-eclampsia with low plasma antithrombin levels had increased risk of preterm delivery when
age, gravidity and booking status were factored (OR, 1.2, 95% CI 0.035 to 0.348, p=0.017).
Conclusions: Lower plasma antithrombin and protein C levels were found with eclampsia and severe pre-eclampsia
suggesting consumptive depletion of anticoagulants with disease progression. Women with pre-eclampsia and low
plasma antithrombin levels were found to have increased odds of having preterm delivery when age, gravidity and
booking status were considered.
Keywords: Antithrombin, Protein C, Pre-eclampsia, Eclampsia, Pregnancy, Sokoto