Antithrombin plasma levels decrease is associated with preeclampsia worsening

Abstract

Antithrombin plasma levels (AT) have been found decreased in women with preeclampsia (PE), but little is known about the trend of AT during the course of this disease. We prospectively investigated AT in consecutive women admitted to our hospital with a diagnosis of PE, to assess if AT fluctuations could be associated with the evolution of the disease. AT, platelet count and D-dimer levels were determined every other day. In the 73 patients studied, AT, platelet count and fibrinogen progressively reduced during the observational period, reaching a nadir on the day of delivery, whereas D-dimer progressively increased over time. Statistical analysis was restricted to the 39 women that had an AT measurement performed on each of days -1, 0 and +1, with respect to the day of delivery. These subjects showed a significant decrease in AT on the day of delivery compared to the day just before (77.8 +/- 15.1%vs. 85.4 +/- 14.2%, P = 0.027), followed by a recovery on the first day after delivery (87.6 +/- 21.3% from 77.8 +/- 15.1%, P = 0.005). Our study demonstrates that a significant drop in AT levels is associated with the clinical worsening of PE, regardless of its severity.

Evaluation of global haemostatic assays and fibrin structure in patients with pre‐eclampsia

“…Possible reasons for this have been suggested to be enhanced consumption due to intravascular coagulation activation, depressed hepatic synthesis and increased urinary loss because of the low molecular weight of AT. 9,35,36 Our study confirmed previous reports of significantly lower AT values in patients with TA B L E 3 Parameters of global haemostatic assays and fibrin clot turbidity analysed in patients with P-EC before and after delivery (n = 42) and in controls (n = 80)…”

Frequency of hereditary thrombophilia, anticoagulant activity, and homocysteine levels in patients with hemolysis, elevated liver functions and low thrombocyte count (HELLP) syndrome

“…Likewise, Marietta et al . determined a correlation between the decreased plasma level of AT‐III and increased hypertensive complications of pregnancy 21 . Osmanagaoglu et al .…”

“…20 Likewise, Marietta et al determined a correlation between the decreased plasma level of AT-III and increased hypertensive complications of pregnancy. 21 Osmanagaoglu et al have also suggested that AT-III may be a useful marker in monitoring the course of the disease. 18 Hyperhomocysteinemia is associated with vascular diseases, such as hypertension, cerebrovascular accidents, peripheral vascular diseases, as well as early pregnancy loss and placental abruption.…”

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

“…[111][112][113][114][115][116][117] Review of 61 women with AFLP found a mean ATIII level of 16.1% (0-69%) compared with mean levels of 60-85% in PET, and 62-80% in HELLP. [118][119][120][121][122][123][124] An ATIII level of less than 65% is suggestive of the diagnosis of AFLP. [124][125][126] Fibrinogen levels rise significantly during pregnancy and the use of non-pregnant reference intervals may underestimate the prevalence of DIC.…”