Factor Viii‐related Antigen and Factor Viii Coagulant Activity in Normal and Pre‐eclamptic Pregnancy

Abstract

The changes in the ratio between factor VIII-related antigen and factor VIII activity were compared in ten patients with normal pregnancies and in ten patients with severe pre-eclampsia. In the patients with pre-eclampsia, a highly significant increase in the ratio was observed during the third trimester. No difference in the ratio between the two groups was found on day 7 of the puerperium. In the pre-eclamptic patients, the highest ratios for factor VIII-related antigen to factor VIII activity were associated with either a perinatal death or with the delivery of a severely growth retarded infant. These findings are in keeping with an increased rate of thrombin production in women with pre-eclampsia, and suggest that the ratio of factor VIII-related antigen to factor VIII activity may reflect the severity of the effect of the disease process on the fetus.

Fibrinogen Concentration and Factor VIII Activity in Women with Preeclampsia

“…While factor VIII activity and fibrinogen concentrations have not been considered to be of great value in this regard, the VWAg/ FVIII ratio has been reported to show a significant increase in PE (11,13,18). By comparison, in this study rises were found in both factor VIII and von Willebrand antigen concentrations from both normal and preeclampsia subjects with a nonsignificant effect on the VWAg/FVIII ratio.…”

“…In cases of preeclampsia, von Willebrand's antigen has been observed to rise both during pregnancy and after delivery, certainly in excess of rises in factor VIII activity, which in some cases fell (10)(11)(12)(13)(14). This resulted in a significant increase in the VWAg/FVIIIC ratio.…”

“…Previously, the majority of studies addressing factor VIII levels in preeclampsia have targeted the disparity that supposedly exists with von Willebrand's antigen (10)(11)(12)(13)(14). Our interest, however, lay in the dual markers of fibrinogen and factor VIII activity, where high levels of either increase the patient's thrombotic risk.…”

Factor VIII levels and the risk of pre-eclampsia, HELLP syndrome, pregnancy related hypertension and severe intrauterine growth retardation

“…In the 1970s and 1980s, several authors reported an elevated ratio of VWF/FVIII:C during pregnancy and an even higher ratio in pregnancies complicated by pre-eclampsia [26][27][28][29] and hypertension [30,31]. Altered coagulation status due to these conditions might increase the factor VIII:C consumption, causing plasma FVIII:C levels to go down.…”

Stress repair mechanism activity explains inflammation and apoptosis

“…Pregnancy is a stressful condition characterized by SRM hyperactivity that elevates blood levels of Factor VIII, generates insoluble fibrin, and increases blood viscosity and coagulability [156,175,194,657,658,662,663]. This is partially offset by Hemodilution anemia during pregnancy that increases blood turbulence and inhibits atherosclerosis [7,8] Eclampsia increases the risk of DIC, especially in the presence of amniotic fluid embolus.…”