Alternations of Maternal and Cord Plasma Hemostasis in Preeclampsia Before and After Delivery

Xiong, Yan; Zhou, Shu‐Feng; Zhou, Rong; Yang, Dongpeng; Xu, Zheng-Fang; Lou, Yiting; Guo, Qing-Sang; Hu, Rong; Peng, Ting; Ma, Ding; Li, Xiaotian

doi:10.3109/10641950903572274

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…The patients with preeclampsia (PE) are known to have higher risk of thromboembolic complications than normal pregnant women [ 4 5 6 7 ]. PE is associated with deposition of fibrin in microvasculature, which results in compromised placental perfusion, fetal growth restriction (FGR) and dysfunction in some maternal organs [ 8 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity

et al. 2017

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ObjectivePregnancy is a major risk factor of thromboembolism, and the patients with preeclampsia (PE) are known to have higher risk of thromboembolic complications than normal pregnant women. D-dimer is a well-established laboratory marker for the screening of venous thromboembolism (VTE), but the concentrations of d-dimer tend to increase physiologically in pregnant women throughout the gestational age. We performed this study to evaluate the clinical significance of d-dimer concentrations in patients with gestational hypertensive disorders (GHD) according to the severity.MethodsRetrospective cohort study was performed in one institution. Singleton pregnant women with GHD were enrolled, and their antepartum concentrations of d-dimer were measured as a part of routine evaluation for patients suspected with PE. Patients with multiple gestations, rheumatic diseases, autoimmune diseases, or suspected VTE were excluded. A categorization of severity about PE was based on the general criteria.ResultsIn 73.3% of study population, their d-dimer concentrations exceeded the normal range (>0.55 mg/L). A significantly greater proportion of pregnant women had excessive concentrations of d-dimer in the severe GHD than in the non-severe GHD (89.8% vs. 53.7%; P<0.01). Patients with severe GHD had significantly higher median concentrations of d-dimer than those with non-severe GHD (median [range], 2.00 mg/L [0.11 to 7.49] vs. 0.71 mg/L [0.09 to 5.39]; P<0.01) although their earlier gestational ages of sampling.ConclusionMaternal concentrations of d-dimer were significantly elevated in patients with severe features than those without severe features among those with GHD. Some pregnant women with GHD can have markedly elevated concentrations of d-dimer without any evidence of current VTE.

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Section: Introductionmentioning

confidence: 99%

The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity

et al. 2017

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“…D Dimer is used as a diagnostic tool for thrombotic conditions as its plasma concentrations has high negative predictive value. Hence, D Dimer has been used as a marker of production or degradation of fibrin invivo [5][6][7] . Gestational hypertension can progress to eclampsia, HELLP syndrome-hemolysis, elevated liver enzymes and low platelet count or disseminated intravascular coagulation.…”

Section: Introductionmentioning

confidence: 99%

“…Gestational hypertension can progress to eclampsia, HELLP syndrome-hemolysis, elevated liver enzymes and low platelet count or disseminated intravascular coagulation. Due to poor placental perfusion, there occurs maternal organ dysfunction and fetal growth restriction [5] . No established datas were available on D Dimer levels as a predictor of gestational hypertension.…”

Section: Introductionmentioning

confidence: 99%

Study of D Dimer as a predictor of severity of Gestational Hypertension

Sangeereni¹,

Kanagarathinam²

2021

Int. J. Clin. Obstet. Gynaecol.

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To study the D dimer levels as a predictor of severity of gestational hypertension. Methodology: A Prospective observational study was performed among the Antenatal women attending the Department of Obstetrics and Gynaecology in our institution. Blood samples were collected from 150 subjects under inclusion criteria and the D Dimer levels were estimated and the same was compared with the severity of the disease. Patients who were COVID positive and who had past history of thrombotic manifestations were excluded from the study. Results: In about 54% of the subjects evaluated, the D Dimer concentrations exceeded the normal range of more than 500 ng/dl. Higher concentrations of D Dimer levels were noted in patients with severe preeclampsia than in those with non-severe preeclampsia. Conclusion: Maternal concentrations of D Dimer were significantly elevated in patients with severe preeclampsia than in those with non-severe disease.

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“…Besides, activated platelets bound on inflamed endothelium induce interactions with neutrophils first, followed by endothelialneutrophil interactions through P-selectin-PSGL-1 receptor binding (29). Soluble P-selectin (sP-selectin), cleavage product of P-selectin released by activated platelets and ECs, has been demonstrated to increase in the plasma of preeclamptic women (30)(31)(32)(33). These studies claimed that higher levels of sP-selectin may confirm the presence of platelet and endothelial cell activation in preeclamptic women.…”

Section: Inflammatory Role Of Platelet Activation In Pementioning

confidence: 99%

Platelets in Preeclampsia: Function and Role in the Inflammation

Şahin¹,

Özakpınar²,

Eroğlu³

et al. 2014

MUSBED

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Preeklampside trombositlerin enflamasyondaki rolü ve etkileriPreeklampsi tüm gebeliklerin %5-8' ini komplike eden gebeliğin hipertansif hastalığıdır. Preeklampsi patogenezinde kılcal damar yatağındaki inflamasyon önemli rol oynar. Preeklampside olduğu gibi dolaşımda serbest halde bulunan mikropartiküllerle trombositlerin karşılaşması sonucunda trombositler aktive olurlar. Aktive olan trombositler dolaşıma serbest moleküller salarlar ve hücre yüzeylerindeki adhezyon moleküllerinin artmasına neden olurlar. Serbest moleküller trombosit, lökosit ve endotel hücreleri arasındaki etkileşimleri düzenlerler. Adhezyon molekülleri de trombosit, lökosit ve endotel hücrelerinin birbirlerine bağlanmasına aracılık ederler. Oluşan trombosit-lökosit agregatları nötrofillerin inflamasyonun olduğu damarsal yapılara göçünün artmasına neden olur. Ayrıca, endotel hücrelerine bağlanan trombositler sitokinlerin yapımına ve inflamatuvar yanıtın artmasına neden olur. Bu derlemede, preeklamptik gebelerde trombosit fonksiyon bozuklukları ve trombositlerin preeklampsi patogenezindeki inflamatuvar rolünden bahsedeceğiz. Anahtar sözcükler: Preeklampsi, trombosit aggregasyonu, trombosit aktivasyonu, inflamasyon ABS TRACT Platelets in preeclampsia: function and role in the inflammationPreeclampsia is a hypertensive disease of pregnancy complicating 5-8% of all pregnancies. A growing body of evidence demonstrated that inflammation in microvasculature plays a major role in the pathogenesis of preeclampsia. Although circulating platelets are in rested state, when they are exposed to soluble mediators or microparticles in the inflamed vasculature as in preeclampsia, platelets are activated by engagement of the mediators on surface receptors. Upon activation, platelets degranulate some soluble and adhesion molecules. When soluble mediators released into the local microenvironment, they modulate the interactions between platelets, leukocytes and endothelial cells. Adhesion molecules expressed on the surface may initiate adherence between platelets, leukocytes and endothelial cells. Platelet-leukocyte aggregates promote the recruitment of neutrophils into the inflamed microvasculature. In addition to this, adherent platelets on endothelial cells induce production of inflammatory cytokines thus lead to amplification of inflammatory response. In this review, we mention platelet dysfunction in preeclamptic pregnancies and inflammatory role of platelets in the pathogenesis of preeclampsia.

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Alternations of Maternal and Cord Plasma Hemostasis in Preeclampsia Before and After Delivery

Cited by 9 publications

References 28 publications

The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity

The clinical significance of D-dimer concentrations in patients with gestational hypertensive disorders according to the severity

Study of D Dimer as a predictor of severity of Gestational Hypertension

Platelets in Preeclampsia: Function and Role in the Inflammation

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