Factors Affecting The Rate Of Protein C ( An Anti Coagulation Factor )

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○ Factors V, VII, VIII, IX, X, XII.1,16,17 ○ von Willebrand factor.16 ○ Decreased levels of fibrinolytic protein C (an anti-coagulation factor).16 ○ Coagulation changes are most pronounced in the third trimester.16 ● Effect on Dental Treatment o The patient’s hypercoagulable state places them at increased risk for thromboembolic disease.17 Because of this, there is an increased risk that the patient may have a thromboembolism while in the dental office. (See the following section titled “Thromboembolic Disease” for additional information.) Thromboembolic Disease ● Background Information ○ Changes in clotting factors place all pregnant women at increased risk for venous thromboembolism.8 ○ During pregnancy, women have a five times…show more content…
○ The patient may be on anticoagulant therapy which may increase risk for bleeding.17 ○ Epinephrine from local anesthetic during intramuscular injections is not thought to significantly increase risk. Accidental intravascular injection may increase risk of activating coagulation.16 (For further information see “Local Anesthetics – The Immediate Post Partum Period” on page …) Antiphospholipid Syndrome (APLS) ● Background Information ○ APLS is a disease where antiphospholipid antibodies bind to phospholipids and may cause thrombosis and fetal loss.1,20 ○ Women with APLS are at significant risk for thromboembolism during pregnancy. They may be placed on anticoagulant therapy to prevent thrombus formation.1,20 ● Presentation in Dental Office ○ The patient may list the medical diagnosis, or medication being taken on the health history. ● Effect on Dental Treatment ○ Provide dental care to these patients in a hospital setting.1 Immune System (IgG) ● Background Information ○ In the second half of pregnancy, immunoglobulin G (IgG) blood levels are decreased.8 ● Presentation in the Dental Office ○ Decreased IgG levels can lead to oral pathogen proliferation. This may allow for sustained oral infections such as periodontal disease.8 ● Effect on Dental Treatment o Emphasize the importance of impeccable at-home oral hygiene care. (Refer to OHI see page ____) Supine (“Frank”) Hypotensive Syndrome ●
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