Plasma levels of von Willebrand factor and fibronectin as markers of persisting endothelial damage in preeclampsia.
OBJECTIVE
To evaluate the levels of von Willebrand factor and fibronectin as markers for the severity of endothelial cell injury in preeclampsia.


METHODS
In 63 pregnant women with preeclampsia, the plasma levels of von Willebrand factor and fibronectin were measured as soon as symptoms were detected, at 5 weeks postpartum, and after lactation. They were also compared with levels in 29 normotensive pregnant women. The von Willebrand factor was measured by enzyme-linked immunoassay and fibronectin was measured using an automated immunonephelometric method.


RESULTS
In preeclampsia, the levels of von Willebrand factor and fibronectin were higher than in normal pregnancy samples drawn in the second and third trimesters. The levels of fibronectin were still elevated at 5 weeks postpartum in women with severe preeclampsia. Four patients with severe preeclampsia who were studied frequently had high levels of von Willebrand factor 5 weeks postpartum.


CONCLUSIONS
The increased maternal plasma levels of von Willebrand factor and fibronectin indicate that endothelial stimulation is present during preeclampsia. The high fibronectin values found even 5 weeks after delivery, at least in patients with severe preeclampsia, may indicate an ongoing vascular disease with increased risk for preeclampsia in subsequent pregnancies.
Division of Obstetrics and Gynecology, Karolinska Hospital/Karolinska Institute, Stockholm, Sweden.
L
L
Deng
K
K
Bremme
L O
LO
Hansson
M
M
Blombäck
D000328:Adult; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005353:Fibronectins / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology; D011247:Pregnancy; D014841:von Willebrand Factor / Q000032:analysis*
D005353:Fibronectins; D014841:von Willebrand Factor