Hemostatic variables as independent predictors for fetal growth retardation in preeclampsia

Schjetlein, Rune; Abdelnoor, Michael; Haugen, Guttorm; Husby, Henrik; Sandset, Per Morten; Wisløff, Finn

doi:10.1034/j.1600-0412.1999.780304.x

Cited by 42 publications

(27 citation statements)

References 23 publications

(37 reference statements)

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“…Our observation that total TFPI plasma concentrations are higher in patients with preeclampsia than in women with a normal pregnancy is in accord with previous reports[131,133]. …”

Section: Discussionsupporting

confidence: 94%

“…Maternal plasma concentrations of TF and free TFPI are higher in women with preeclampsia than in patients with a normal pregnancy[131–133]. However, the differences in the maternal plasma concentrations of TF and TFPI between patients with preeclampsia and those who delivered an SGA neonate, as well as the differences between patients who delivered an SGA neonate and women with a normal pregnancy, have been poorly studied.…”

Section: Introductionmentioning

confidence: 99%

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Tissue factor and its natural inhibitor in pre-eclampsia and SGA

Erez

Romero

Hoppensteadt

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Tissue factor (TF), the major activator of the extrinsic pathway of coagulation, is abundant in the placenta and decidua. The aim of this study was to determine the maternal plasma concentrations of TF and its primary inhibitor, tissue factor pathway inhibitor (TFPI), in women who delivered small for gestational age (SGA) neonates, and in preeclampsia. Study Design A cross-sectional study included the following groups: 1) women with normal pregnancies (n=86); 2) patients who delivered SGA neonates (n=61); and 3) women with preeclampsia (n=133). Maternal plasma concentrations of TF and TFPI were measured by a sensitive immunoassay. Non-parametric statistics were used for analysis. Results 1)Women with preeclampsia had a significantly higher median plasma concentration of TF than patients with a normal pregnancy (median: 1187 pg/ml; range: 69–11675 vs. median: 291.5 pg/ml; range: 6.3–2662.2; p<0.0001, respectively); 2) Similarly, TFPI concentrations were higher in preeclampsia than in normal pregnancy (median: 87.5ng/ml; range 25.4–165.1 vs. median: 66.1 ng/ml; range: 14.3–86.5; p<0.0001, respectively); 3) Surprisingly, mothers with SGA neonates had a lower median maternal plasma concentration of TF (median: 112.2 pg/ml; range: 25.6–1225.3) than women with a normal pregnancy (p<0.0001). Conclusion 1) Maternal plasma concentrations of TF in patients with preeclampsia, but not in those who delivered an SGA neonate, were higher than in women with normal pregnancies; 2) While the role of immunoreactive plasma TF in coagulation remains controversial, our observations suggest that changes are present in the context of complications of pregnancy.

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“…Our observation that total TFPI plasma concentrations are higher in patients with preeclampsia than in women with a normal pregnancy is in accord with previous reports[131,133]. …”

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Tissue factor and its natural inhibitor in pre-eclampsia and SGA

Erez

Romero

Hoppensteadt

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

View full text Add to dashboard Cite

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“…The hypercoagulability of PE has been attributed to endothelial dysfunction, decreased antithrombin levels, and increased levels in markers of thrombin activity [9, 11]. Other proteins involved in hemostasis such as factor VIII, soluble fibrin, thrombomodulin and D-dimer are also reported to be altered in PE [12–16]. …”

Section: Introductionmentioning

confidence: 99%

Coagulation and fibrinolytic system protein profiles in women with normal pregnancies and pregnancies complicated by hypertension

Hale

Sobel

Benvenuto

et al. 2012

Pregnancy Hypertension: An International Journal of Women's Car

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Objective The current study longitudinally evaluated concentrations of fibrinogen (Fib), D-Dimer, plasminogen activator type-1 (PAI-1) and tissue type plasminogen activator (T-Pa) before pregnancy and in the first and third trimesters of pregnancy with a focus on the pregnancy transition. Study design Twenty healthy, nonsmoking, nulliparous women, aged 29.8 ± 3.0 years, BMI 23.3 ± 3.2 kg/m2 were studied during menstrual cycle day 8 ± 4 and again in early (11 – 15 wks) and late (31 – 34 wks) pregnancy. Seventeen women had singleton conceptions and delivered at term with uncomplicated pregnancies (CTL) and three women developed complicated hypertension (CH) during pregnancy after the third trimester (late pregnancy) evaluation. Data are means ± SEM, Significance was based on p < 0.05. Results Fib was the only protein evaluated that increased in early pregnancy relative to the prepregnancy assessment. D-dimer, PAI-1 and T-Pa increased in the third trimester compared with prepregnant and early pregnant values (p < .001). T-PA was significantly higher during late pregnancy in CH subjects compared with CTL (8.1 ± 0.7 ng/ml vs. 5.0 ± 0.2 ng/ml, p = .02). There were no other differences between groups. Conclusions Increases in fibrinogen are evident in early pregnancy whereas fibrinolysis, perhaps in response to the procoagulant environment of pregnancy, is increased during late pregnancy. Before development of clinically overt hypertension, T-Pa is increased without concomitant changes in other proteins assessed. This is consistent with altered endothelial function with preeclampsia that may contribute to, or reflect, the vasculopathy accompanying this disorder.

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“…Maternal plasma concentrations of TF and free TFPI are higher in women with preeclampsia than in patients with a normal pregnancy [39-41]. Placental TF concentrations and mRNA expression are higher in patients with severe preeclampsia than in those with a normal pregnancy [42].…”

Section: Introductionmentioning

confidence: 99%

A link between a hemostatic disorder and preterm PROM: a role for tissue factor and tissue factor pathway inhibitor

Erez

Espinoza

Chaiworapongsa

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective-Vaginal bleeding is a risk factor for preterm PROM (PPROM). A disorder of decidual hemostasis has been implicated in the genesis of PROM. Indeed, excessive thrombin generation has been demonstrated in PPROM both before and at the time of diagnosis. Decidua is a potent source of tissue factor (TF), the most powerful natural pro-coagulant. A decidual hemostatic disorder may link vaginal bleeding, PPROM, and placental abruption. This study was conducted to determine the behavior of maternal TF and its natural inhibitor, the tissue factor pathway inhibitor (TFPI) in PPROM.Methods-This cross-sectional study included women with PPROM (n=123) and women with normal pregnancies (n=86). Plasma concentrations of TF and TFPI were measured by a sensitive immunoassay. Non-parametric statistics were used for analysis. Results-1)The median maternal plasma TF concentration was significantly higher in patients with PPROM than in women with normal pregnancies (median: 369.5 pg/ml; range: 3.27-2551 pg/ ml vs. median: 291.5 pg/ml; range: 6.3-2662.2 pg/ml, respectively; p=0.001,); 2) the median maternal TFPI plasma concentration was significantly lower in patients with PPROM than in women with a normal pregnancies (median: 58.7 ng/ml; range: 26.3-116 ng/ml vs. median: 66.1 ng/ml; range: 14.3-86.5 ng/ml, respectively; p=0.019); 3) there was no correlation between the plasma concentration of TF and TFPI and the gestational age at sample collection; and 4) among patients with PPROM there was no association between the presence of intra-amniotic infection or inflammation and median plasma concentrations of TF and TFPI. Conclusions-1) Patients with PPROM have a higher median plasma concentration of TF and a lower median plasma concentration of TFPI than women with normal pregnancies. 2) These findings suggest that PPROM is associated with specific changes in the hemostatic/coagulation system. NIH Public Access

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Hemostatic variables as independent predictors for fetal growth retardation in preeclampsia

Abstract: Our results are consistent with activated coagulation in the placental vessels in preeclampsia. A low concentration of PAI-2 antigen in plasma emerged as the most consistent risk factor for preeclampsia and FGR.

Cited by 42 publications

References 23 publications

Tissue factor and its natural inhibitor in pre-eclampsia and SGA

Tissue factor and its natural inhibitor in pre-eclampsia and SGA

Coagulation and fibrinolytic system protein profiles in women with normal pregnancies and pregnancies complicated by hypertension

A link between a hemostatic disorder and preterm PROM: a role for tissue factor and tissue factor pathway inhibitor

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