Markers of intravascular coagulation and fibrinolysis in preeclampsia: association with intrauterine growth retardation

Schjetlein, Rune; Haugen, Guttorm; Wisløff, Finn

doi:10.3109/00016349709024580

Cited by 72 publications

(48 citation statements)

References 31 publications

(11 reference statements)

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“…Furthermore, the level of D-dimer is elevated slightly to compensate for hypercoagulation [19]. In the present study, the mean AT III activity for the grade III group was lower than that of the other groups, whereas no significant differences in the level of TAT were found between the three groups.…”

Section: Discussionmentioning

confidence: 43%

Correlation between Grade III Placenta and Plasma Antithrombin III Activity in Full Term Pregnancy

Asakura¹,

Ohshita²,

Suzuki³

et al. 2001

Gynecol Obstet Invest

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We evaluated whether the presence of a grade III placenta correlates with blood hypercoagulability in pregnancy between 37 and 39 weeks of gestation. The placenta was graded by ultrasound in 155 healthy full-term women and the plasma levels of antithrombin III (AT III) activity, thrombin-antithrombin complex (TAT) and D-dimer were correlated with each placental grade. AT III activity levels tended to decrease with advancing placental grade from I to III (p < 0.05). D-dimer showed the same tendency while TAT did not. The incidence of reduced AT III activity levels (<70%) in women with a grade III placenta was about twice those in women with a grade II or I placenta, and that of AT III <80% was 3-fold greater. We concluded that the presence of a grade III placenta in full-term pregnancies correlates with blood hypercoagulability.

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Section: Discussionmentioning

confidence: 43%

Correlation between Grade III Placenta and Plasma Antithrombin III Activity in Full Term Pregnancy

Asakura¹,

Ohshita²,

Suzuki³

et al. 2001

Gynecol Obstet Invest

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“…Normal pregnancy is characterized by an increased plasma concentration of protein Z [37], which has been proposed to be part of a compensatory mechanism for the increased concentration of factor X [37] and perhaps for the increased thrombin generation. Preeclampsia is associated with an exaggerated hypercoagulable state and excessive thrombin generation [1,25,38], as determined by higher maternal plasma concentrations of TAT complexes [25][26][27][28]39,40] and lower antithrombin III concentrations [41][42][43][44][45] than patients with normal pregnancies. Moreover, patients with PE who deliver preterm have a higher rate of thrombotic lesions in the decidua [9,20] and in the placental villi [23] than normotensive patients with indicated or spontaneous preterm delivery [20,23].…”

Section: Discussionmentioning

confidence: 99%

Preeclampsia is associated with low concentrations of protein Z

Erez

Hoppensteadt

Romero

et al. 2007

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective. Protein Z, a vitamin K-dependent plasma protein, has an important role in the regulation of the coagulation cascade. Protein Z deficiency has been associated with unexplained pregnancy loss and adverse pregnancy outcome in patients with thrombophilia. This study was conducted to determine if preeclampsia (PE), small for gestational age (SGA), and fetal demise are associated with changes in maternal plasma concentrations of protein Z. Study design. This cross-sectional study included normal pregnant women (N ¼ 71), patients with PE (N ¼ 130), patients who delivered an SGA neonate (N ¼ 58), and patients with fetal demise (N ¼ 58). Maternal plasma protein Z concentrations were measured by a sensitive and specific immunoassay. Protein Z deficiency was defined as maternal plasma concentrations 5 th percentile of the normal pregnancy group (1.59 mg/mL). Non-parametric statistics were used for analysis.Results.(1) Patients with PE had a lower median plasma concentration of protein Z than normal pregnant women (PE: median 1.6 mg/mL, range 0.2-3.3 mg/mL vs. normal pregnancy: median 2.4 mg/mL, range 1.1-3.4 mg/mL; p 5 0.0001); (2) patients with an SGA neonate (median 2.3 mg/mL, range 0.2-3.8 mg/mL) and fetal demise (median 2.6 mg/mL, range 0.2-4.3 g/mL) did not have significantly different median protein Z concentrations from normal pregnant women (p 4 0.05); and (3) women in the PE and fetal demise groups had significantly higher rates of protein Z deficiency than those with normal pregnancy outcome. Conclusions.(1) PE, but not SGA or fetal demise, is associated with a significantly lower maternal median plasma concentration of protein Z than normal pregnancy, and (2) a high rate of protein Z deficiency is observed in patients with PE and fetal demise.

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“…Binding of FVII to the exposed TF on the surface of monocytes may result in the low FVII concentration seen in women with P-EC [25,26]. It could also be due to reduced production, and/or increased consumption, following placental separation [27,28], consistent with increased intravascular coagulation and fibrin turn-over [29,30].…”

Section: Discussionmentioning

confidence: 88%

Tissue factor-dependent pathway in severe preeclampsia revisited

Dusse

Godói

Gomes

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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Previously we investigated the tissue factor (TF)-dependent coagulation pathway and key haemostatic cofactors in white women with preeclampsia (P-EC) and suggested that plasma factor VII (FVII) levels can differentiate women with P-EC from healthy nonpregnant women or normal pregnant women, at the same trimester, with high sensitivity, specificity, positive and negative predictive values. Here we re-examine the TF-dependent pathway in a large cohort of Brazilian women. A total of 240 women were studied. These included healthy nonpregnant women (n = 79), normotensive pregnant women (n = 80) and women with severe P-EC (n = 81). Commercially available enzyme-linked immunosorbent assays were used to measure plasma FVII, activated factor VII (FVIIa), TF and tissue factor pathway inhibitor (TFPI). All study participants were matched for age. Pregnant women (with/without P-EC) were matched for gestational age and parity. Plasma levels of FVII, FVIIa and TFPI were significantly increased in women with severe P-EC compared with healthy nonpregnant women (P < 0.01) or normotensive pregnant women (P < 0.01). FVIIa was also higher in normotensive pregnant women compared with nonpregnant women (P < 0.01). However, no such significant trends were observed for plasma TF levels (P = 0.074). In conclusion, circulating FVII, FVIIa and TFPI were significantly elevated in women with severe P-EC in the absence of comparable changes in plasma TF levels. The present work is in agreement with our previous report on FVII levels in white women with P-EC. Thus, this lends further support to the notion that plasma FVII levels are potentially valuable diagnostic marker for P-EC, irrespective of ethnicity.

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Markers of intravascular coagulation and fibrinolysis in preeclampsia: association with intrauterine growth retardation

Abstract: We found evidence of increased intravascular coagulation and fibrin turnover in preeclampsia. Low PAI-2 antigen plasma levels were associated with severe preeclampsia and IUGR.

Cited by 72 publications

References 31 publications

Correlation between Grade III Placenta and Plasma Antithrombin III Activity in Full Term Pregnancy

Correlation between Grade III Placenta and Plasma Antithrombin III Activity in Full Term Pregnancy

Preeclampsia is associated with low concentrations of protein Z

Tissue factor-dependent pathway in severe preeclampsia revisited

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