Coagulation inhibitors in preeclamptic pregnant women

Osmanağaoğlu, Mehmet A.; Topçuoğlu, Kenan; Özeren, Mehmet; Bozkaya, Hasan

doi:10.1007/s00404-003-0596-4

Cited by 23 publications

(21 citation statements)

References 19 publications

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“…We found that the PC activity of preeclamptic pregnant women was lower than that of healthy pregnant and non‐pregnant women. In contrast, there were no significant differences between the PC activities of the preeclamptic and healthy pregnant groups in two studies 18,19. …”

Section: Discussionmentioning

confidence: 68%

Natural coagulation inhibitors and active protein c resistance in preeclampsia

Demir

Dılek²

2010

Clinics

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INTRODUCTION:The etiology of preeclampsia is not fully established. A few studies have shown a relationship between natural coagulation inhibitors and preeclampsia.OBJECTIVES:The purpose of this study was to investigate the status of natural coagulation inhibitors and active protein C resistance (APC‐R) in preeclampsia.PATIENTS AND METHODS:We studied 70 women with preeclampsia recruited consecutively and 70 healthy pregnant and 70 nonpregnant women as controls. Plasma protein C (PC), free protein S (fPS), antithrombin III (ATIII) and APC‐R were evaluated.RESULTS:ATIII values were found to be significantly lower in preeclamptic patients than in the control groups (p< 0.001). Nevertheless, there was no significant difference between the healthy pregnant and nonpregnant women groups (p = 0.141). The fPS values of the preeclamptic and healthy pregnant groups were lower than that of the nonpregnant group (p< 0.001), and the fPS value of the preeclamptic pregnant women was lower than that of healthy pregnant women (p<0.001). The PC value of the preeclamptic pregnant women was lower than that of the control groups (p< 0.001). The PC value of the healthy pregnant women was lower than that of the nonpregnant women (p< 0.001). The mean APC activity values were lower in the preeclamptic patients than that of the control groups (p< 0.001, p< 0.001). The APC‐R positivity rates of the preeclamptic groups were higher than that of the control groups (p<0.001).CONCLUSIONS:This study demonstrated that ATIII, fPS, PC values and APC resistance were lower and APC‐R positivity was higher in preeclamptic women than in normal pregnant and nonpregnant women.

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Section: Discussionmentioning

confidence: 68%

Natural coagulation inhibitors and active protein c resistance in preeclampsia

Demir

Dılek²

2010

Clinics

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“…, 1999; Kobayashi et al. , 2001, 2002; Osmanagaoglu et al. , 2005) and some authors have suggested that the assessment of this parameter could assist in differentiating PE from other forms of gestational hypertension, in which AT is unchanged (De Boer et al.…”

Section: Discussionmentioning

confidence: 99%

Antithrombin plasma levels decrease is associated with preeclampsia worsening

Simoni

Pedrazzi

Facchini

et al. 2009

Int J Lab Hematology

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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.

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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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Coagulation inhibitors in preeclamptic pregnant women

Cited by 23 publications

References 19 publications

Natural coagulation inhibitors and active protein c resistance in preeclampsia

Natural coagulation inhibitors and active protein c resistance in preeclampsia

Antithrombin plasma levels decrease is associated with preeclampsia worsening

Preeclampsia is associated with low concentrations of protein Z

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