Evaluation of six markers of haemostatic system in normal pregnancy and pregnancy complicated by hypertension or pre-eclampsia.
OBJECTIVE
To establish the plasma evolution of prothrombin fragments 1+2 (F 1+2), thrombin-antithrombin III complexes (TAT), fibrin fragment D-Dimers (DD), von Willebrand factor antigen (vWf), Type 1 plasminogen activator inhibitor antigen (PAI) and blood platelet count during normal pregnancy and to compare these values with those obtained in hypertensive or pre-eclamptic pregnancies.


METHODS
Cross-sectional study.


METHODS
Forty-seven healthy pregnant women with gestational age ranging between 5 and 40 weeks, and fourteen women with gestational age ranging between 25 and 38 weeks presenting with either gestational hypertension (n = 4) or pre-eclampsia (n = 10). Numbers of nulliparous women in the control, hypertension and pre-eclampsia groups were 13/47 (28%), 1/4 (25%) and 9/10 (90%), respectively.


RESULTS
All six markers increased with gestational age in normal pregnant women (P < 0.01). Using the upper limit of 95% prediction interval obtained from regression curves as normality threshold, TAT showed the best sensitivity (71% vs < 30% for F1+2, DD, vWf, PAI and platelet count).


CONCLUSIONS
TAT appears to be an interesting marker for detecting haemostatic system alterations in pregnancies complicated by hypertension or pre-eclampsia. A large prospective study to determine its clinical usefulness for such complicated pregnancies is currently in progress.
Cadroy
Y
Y
Laboratoire d'Hémostase, Centre de Transfusion Sanguine, Toulouse, France.
Grandjean
H
H
Pichon
J
J
Desprats
R
R
Berrebi
A
A
Fournié
A
A
Boneu
B
B
D000328:Adult; D000933:Antifibrinolytic Agents / Q000097:blood; D000941:Antigens / Q000032:analysis; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D006973:Hypertension / Q000097:blood*; D010446:Peptide Fragments / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000276:immunology; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood*; D011498:Protein Precursors / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D012680:Sensitivity and Specificity; D014841:von Willebrand Factor / Q000032:analysis
D000933:Antifibrinolytic Agents; D000941:Antigens; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; D011498:Protein Precursors; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D014841:von Willebrand Factor; C029733:prothrombin fragment 1; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases