SummaryIn the present study, we explored the microparticles involved in the control of hemostatic equilibrium, i.e microparticles originating from platelet, endothelial cells and total MP defined as annexin V positive microparticles. Our aim was to analyze the level and procoagulant activity of these microparticles in normal pregnancy and pregnancies complicated with preeclampsia or isolated intrauterine growth restriction. We reported increased levels of platelet and endothelial microparticles in normal pregnancy compared to non pregnant healthy women. Number of annexin V microparticles was significantly increased together with their procoagulant activity. In pathological pregnancies, significant reduction in platelet microparticle number was found in preeclampsia. The procoagulant activity generated by the total annexin V MP was unchanged, suggesting that the microparticles remaining in the circulation were pro-coagulant. This study evidenced that microparticles constitute a cellular marker of a proinflammatory and procoagulant responses in normal pregnancy. In pregnancies with vascular complications, circulating MP with procoagulant potential may be part of the exacerbation of these responses.

LM. Genetic risk factors in acute coronary disease. Haemostasis 1999 (in press). 2. Brattstrom L, Wilcken DE, Ohrvik J, Brudin L. Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease: the result of a meta-analysis.

Medicaid, the nation's health care safety net, has come under increasing pressure as most state governments face a fiscal crisis. Cutbacks in funding that decrease already inadequate reimbursement, the tightening of eligibility, and a reduction of benefits will lead to an increase in the under- and uninsured, further straining the ability of hospitals to remain solvent and provide care to this vulnerable population. The federal government must increase funding to the Medicaid program and the Medicaid hospital disproportionate share while state governments must continue a level of funding that will not cause a loss of federal matching funds. Both state and federal governments must be held accountable for providing the necessary financial support to providers through the Medicaid program so that they can continue to serve their nearly 51 million poor, disabled, and elderly patients.