The fibrinolytic system in pre-eclampsia.

Gow, L; Campbell, D. M.; Ogston, D.

doi:10.1136/jcp.37.1.56

Cited by 43 publications

(7 citation statements)

References 9 publications

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“…PAI‐1 is the more efficient inhibitor of plasminogen activators (Jorgensen et al 1987) and its rise in plasma probably accounts for the rise in overall PA inhibitory activity seen in pre‐eclampsia, overwhelming the relatively smaller functional contribution of PAI‐2. Certainly the overall depression of fibrinolytic activity appears to centre on inhibition of plasminogen activator rather than inhibition of plasmin itself, as plasma alpha‐ 2 anti‐plasmin levels showed no detectable differences between pre‐eclamptic and uncomplicated pregnancies (Gow et al 1983; Asnar et al 1986; de Boer et al 1988), nor was any difference in levels of subsidiary inhibitors of plasmin, namely alpha‐ 2 macroglobulin, alpha 1 ‐antitrypsin and anti‐thrombin III, observed (Gow et al 1984).…”

Section: Discussionmentioning

confidence: 99%

Plasminogen activator inhibitors (PAI‐1 and PAI‐2) in normal pregnancies, pre‐eclampsia and hydatidiform mole

Reith¹,

Booth²,

Moore³

et al. 1993

BJOG

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Objective To examine the behaviour of the major inhibitors of fibrinolysis (PAI‐1 and PAI‐2) in normal pregnancy and pregnancy complicated by either pre‐eclampsia or hydatidiform mole. Design Prospective study. Setting Antenatal Clinic and Maternity Hospital. Subjects Eleven women with established pre‐eclampsia and eleven women, matched by age, parity, and duration of pregnancy who were undergoing uncomplicated pregnancy. Two women having surgery for hydatidiform mole. Main outcome measure Plasma levels of PAI‐1 and PAI‐2 antigens determined by sensitive specific ELISA. Functional identification of PAI‐2 by nondenaturing gel electrophoresis with overlay zymography. Results In pre‐eclampsia PAI‐2 antigen was significantly lower than in normal pregnancy (105.3 ± 34.9 versues 187.1 ± 67.9 ng/ml; P<0.001). In contrast PAI‐1 antigen was significantly higher in pre‐eclampsia than in normal pregnancy (170.7 ± 71.2 versus 113.8 ± 35.6 ng/ml; P<0.05). In consequence the ratio of PAI‐1/PAI‐2 increased markedly in pre‐eclampsia (2.5 versus 0.6). No PAI‐2 was detected in plasma of women with hydatidiform moles. Conclusions PAI‐2 levels fell significantly in pre‐eclampsia probably as a result of decreased placental mass or function. The raised PAI‐1 level in pre‐eclampsia may reflect a response to hypertension or renal damage that is not specific to pregnancy or may reflect altered placental function. The use of the ratio of PAI‐1/PAI‐2 assists in separating normal from abnormal pregnancies.

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Section: Discussionmentioning

confidence: 99%

Plasminogen activator inhibitors (PAI‐1 and PAI‐2) in normal pregnancies, pre‐eclampsia and hydatidiform mole

Reith¹,

Booth²,

Moore³

et al. 1993

BJOG

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“…In early studies on fibrinolysis in preeclampsia a diminished sensitivity to urokinase-induced fibrinolysis was found, 27,28 but most investigators could find no difference between fibri nolytic activity and inhibitory activity between normal pregnancy and preeclampsia. 29 Recently, further inves tigations in preeclampsia have been reported using new methodology. Aznar et al 30 found that in severe preec lampsia the levels of the fast-acting PAI were higher than normal pregnancy and the levels of protein C antigen and activity were decreased.…”

Section: Fibrinolysis and Preeclampsiamentioning

confidence: 99%

Changes in the Fibrinolytic System During Pregnancy

Bonnar

Daly²,

Sheppard³

1990

Semin Thromb Hemost

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“…The relative risk of venous thrombosis or pulmonary embolism in pregnancy or puerperium is 5.5 times that expected in non-pregnant women not taking oral contraceptives (Coon, 1977). Numerous investigations of haemostasis during pregnancy have involved subjects with antenatal complications (Finnerty and Mackay, 1962 Laros and Alger, 1979; Talbert and Blatt, 1979; Weenink et af., 1983; Gow et al. 1984).…”

Section: Introductionmentioning

confidence: 98%

Haemostatic trends in normal pregnancy in Chinese women

Koh

Ratnam

1989

Journal of Obstetrics and Gynaecology

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Hacmostatic trends during the course of normal prcgnancy were studied in 256 Chinese women at the University Department of Obstetrics and Gynaecology, Kandang Kerbau Hospital in Singapore. using 282 nonpregnant women for comparison. Fibrinogen, factor VIIIC, VIIIR:Ag, factor X and a,-antitrypsin all rose above the mean non-pregnant levels throughout pregnancy; factor I1 did not show a marked deviation whereas factor V rose in the first and second trimesters and fell to a non-pregnant level in the third trimester. Antithrombin 111 antigen was reduced throughout pregnancy, csptcially near term. Platelet count was reduced throughout pregnancy with no appreciable change in adhesiveness and a slightly more sensitive aggregation in virro to adenosine diphosphate was observed from the second trimester. Fibrin-fibrinogen degradation products were increased from 21 weeks pregnant. The findings suggest a low level of intravaxular coagulation starting in early pregnancy. T h e hypercoagulable state during the last part of pregnancy appeared to have teen minimised by increasing fibrinolytic activity. This may explain the comparatively low incidence of thrombo~mbolic discase in Chinese women in Singapore. Whole blood fibrinolytic activity in normal andhypertensive pregancies and its relation to the placental concentration of urokinase inhibitor. American Jour-no1 o j Obstetrics and Gynecology 133, 624-629. Astedt B., Isanon S., Nilsson I. M. & Pandolfi M. (1970) Fibrinolytic activity of veins during pregnancy. Act0 Obstetricio et Gynecologica Scondinovico 49, I7 1-1 73.

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The fibrinolytic system in pre-eclampsia.

Cited by 43 publications

References 9 publications

Plasminogen activator inhibitors (PAI‐1 and PAI‐2) in normal pregnancies, pre‐eclampsia and hydatidiform mole

Plasminogen activator inhibitors (PAI‐1 and PAI‐2) in normal pregnancies, pre‐eclampsia and hydatidiform mole

Changes in the Fibrinolytic System During Pregnancy

Haemostatic trends in normal pregnancy in Chinese women

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