Source of increased plasminogen activators during pregnancy and puerperium

Shimada, Hayato; Takashima, E; Soma, Masayuki; Murakami, Masahirô; Maeda, Yukihide; Kasakura, S; Takada, Akikazu; Takada, Yumiko

doi:10.1016/0049-3848(89)90039-x

Cited by 29 publications

(10 citation statements)

References 13 publications

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“…We found that the t-PA antigen level increased gradually during pregnancy. As t-PA has been shown to be produced mainly by endothelial cells, this result shows that the change was caused by a change in the cardiovas cular system during pregnancy [11,12]. The u-PA antigen level is constant in nonpregnant women [13,14], but increases gradually during pregnancy, because u-PA is produced by placental tissue and because its level in creased with growth of placental tissue [11].…”

Section: Discussionmentioning

confidence: 91%

Fibrinolysis during Normal Pregnancy and Severe Preeclampsia Relationships between Plasma Levels of Plasminogen Activators and Inhibitors

Nakashima

Kobayashi

Terao

1996

Gynecol Obstet Invest

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The antigen levels of plasminogen activator inhibitor type 1 (PAI-1), plasminogen activator inhibitor type 2 (PAI-2), tissue-type plasminogen activator (t-PA), and urokinase-type plasminogen activator (u-PA) were measured during pregnancy and severe preeclampsia. The PAI-1 and PAI-2 antigen levels increased linearly during pregnancy and promptly returned to the level of non-pregnant women after delivery. The t-PA and u-PA antigen levels increased slowly and linearly during pregnancy. In severe preeclampsia, the PAI-2 antigen level was lower than that observed during the 3rd trimester of normal pregnancy, and the t-PA antigen level was higher than that during the 3rd trimester of normal pregnancy. Immunohistochemical examination of placental tissue showed that the PAI-2 and u-PA antigens were localized in syncytio-trophoblasts. In severe preeclampsia, the PAI-2 and u-PA antigens in placental tissue did not stain as clearly as during the 3rd trimester of normal pregnancy. The PAI-2 and u-PA antigen levels showed a positive correlation with birth weight. Therefore, PAI-2 may be an important marker of placental function and abnormality in pregnancies.

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Section: Discussionmentioning

confidence: 91%

Fibrinolysis during Normal Pregnancy and Severe Preeclampsia Relationships between Plasma Levels of Plasminogen Activators and Inhibitors

Nakashima

Kobayashi

Terao

1996

Gynecol Obstet Invest

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“…Enhanced coagulation activation in early pregnancy has been suggested in Caucasians (1) and Asians (4); and in Asians increased fibrinolytic activity and fibrinolytic inhibitors were found in late pregnancy (4,5) while others have reported decreased fibrinolytic activity in Caucasians (6,7). Increased fibrinolytic activity following placental separation has been observed (5,(8)(9)(10) with enhanced activation of coagulation during labor and delivery (10)(11)(12). The fibrinolytic system changes dramatically, probably due to release of plasminogen activators from the vessel walls induced by delivery that overwhelms the fibrinolytic inhibitor plasminogen activator inhibitor (PAI)-l (5,13).…”

mentioning

confidence: 93%

The Influence of Labor and Placental Separation on Hemostasis in Term Pregnancy

Koh

Arulkumaran

Biswas

et al. 1998

Clin Appl Thromb Hemost

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We studied the hemostatic effects in 68 term preg nant subjects with normal pregnancy (n = 39), gestational diabetes mellitus (n = 21), pregnancy-induced hypertension (n = 8), during labor, after placental separation, and at 24 hours postpartum. During labor, a hypercoagulable state with en hanced fibrinolysis and platelet activation along with elevated plasminogen activator inhibitor-1 and plasminogen activator inhibitor-2 were seen. In all cases following placental separa tion, enhanced fibrinolysis persisted with further elevated tissue plasminogen activator antigen and D-dimer levels, increased thrombin generation and platelet activation with decreasing plasminogen activator inhibitor-1 levels. By 24 hours postpar tum, thrombin generation (thrombin-antithrombin complex) decreased to a nonpregnant level except for pregnancy induced hypertension, but enhanced prothrombin activation (F1+2) was evident in normal, gestational diabetes mellitus and pregnancy- induced hypertension. Reduced total protein S and antithrom bin III activity with normal protein C and elevated fibrinogen levels seen during labor were not affected by delivery. How ever, although factor VII showed a decreasing trend at 24 hours postpartum it remained elevated above the normal nonpregnant level. At 24 hours postpartum, a hypercoagulable state still persisted in normal, gestational diabetes mellitus and preg nancy-induced hypertension term pregnancy accompanied by enhanced fibrinolysis and elevated plasminogen substrate for fibrinolysis, suggesting a critical dynamic equilibrium between a thrombotic and hemorrhagic state.

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“…Plasminogen activators and PAIs are found at elevated levels in the blood of pregnant women and in gestational tissues [11–14], During pregnancy, activity and antigen levels of uPA are found elevated in plasma [7,15,16], peaking around the third trimester, fall during labor, and return to normal non-pregnant levels post-partum [6]. …”

Section: Introductionmentioning

confidence: 99%

Plasminogen activator activity in tears of pregnant women

et al. 2017

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PurposePlasminogen activator activity (PAA) in tears of pregnant women was investigated at various gestation times to assess the availability of plasminogen activator for aiding potential corneal wound healing processes during pregnancy.MethodsPAA was measured by a spectrophotometric method. The analysis used 91 tear samples from pregnant and non-pregnant women, supplemented with 10 additional tear PAA measurements from non-pregnant women obtained in a previous study.ResultsTear levels of PAA in pregnant women formed a bimodal distribution. Either the tear PAA level was zero or non-zero during pregnancy. When non-zero, the tear PAA level was dissociated from gestation time and not different than non-pregnant and post-pregnant levels. The frequency of occurrence of zero level tear PAA increased with gestation: 16%, 17% and 46% had zero tear PAA in samples taken from women in the first, second and third trimester, respectively.ConclusionsOverall, of the tear samples taken from women during pregnancy, a total of 26% were at zero tear PAA. The remaining tear samples had non-zero tear PAA values throughout gestation equivalent to non-pregnant tear PAA values, suggesting local control of the source of PAA in tears. Given the importance of the plasminogen activator system in tears to wound healing in the cornea, and the high occurrence of zero tear PAA in our sample of pregnant women, elective corneal surgery would be contraindicated. If corneal surgery is nevertheless necessary, the tear PAA level would be worth checking and patients with low level should be closely observed during the postoperative period.

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Source of increased plasminogen activators during pregnancy and puerperium

Cited by 29 publications

References 13 publications

Fibrinolysis during Normal Pregnancy and Severe Preeclampsia Relationships between Plasma Levels of Plasminogen Activators and Inhibitors

Fibrinolysis during Normal Pregnancy and Severe Preeclampsia Relationships between Plasma Levels of Plasminogen Activators and Inhibitors

The Influence of Labor and Placental Separation on Hemostasis in Term Pregnancy

Plasminogen activator activity in tears of pregnant women

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