Objectives: The main components of protein C anticoagulant system are protein C (PC), protein S (PS) and thrombomodulin (TM); the system plays a protective role in pregnancy, mainly because it prevents the utero-placental circulation from local thrombosis. It is unknown whether the protein C anticoagulant pathway exists in amniotic fluid. The aim of the present study is to find out whether these three components are present in amniotic fluid.
Study Design: The study group consisted of 50 parturients with an uneventful pregnancy and birth and 25 non-pregnant controls. Amniotic fluid and blood were sampled at the end of the 1st stage of labor. PC, PS and TM were measured by immunoenzymatic method.
Results: All the samples of amniotic fluid contained measurable amounts of antigens of PC, PS and TM, although their concentrations were significantly lower than in the mother's blood: (i) The concentration of PC in amniotic fluid was 6.24+/-3.50% and PS 2.40+/-1.64%, while in the mothers' plasma it was 138.26+/-12.38% and 93.15+/-13.24%, respectively (P<0.0001). (ii) TM concentration in amniotic fluid constituted 63.92% of the concentration in the mother's blood (2.71+/-1.21 ng/mL vs. 4.24+/-0.88 ng/mL, P<0.001).
Conclusion: Protein C, protein S and thrombomodulin are physiological constituents of the amniotic fluid. As their concentrations are low, it is reasonable to assume that they cannot counterbalance the procoagulant activity of amniotic fluid.
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