Thrombomodulin: a new marker for placental abruption.
Thrombomodulin (TM), a marker of endothelial cell damage, has been localized to the placental syncytiotrophoblast. A prospective cohort study of twenty-five pregnant women who were admitted with a clinical diagnosis of placental abruption was undertaken. Abruption was confirmed after delivery in eight cases (Group 1). Group 2 consisted of seventeen patients with no clinical or pathologic evidence of placental abruption after delivery. TM was significantly elevated in Group 1 (71.59+/-5.35 vs. 48.29+/-3.53 ng/ml, p = 0.001). The sensitivity and specificity of TM > or =60 ng/ml as a marker for abruption was 87.5 and 76.5%, respectively. In comparison, the sensitivity of an abnormal coagulation profile, maternal Kleihauer-Betke and ultrasound in patients with abruption was 0, 16.7 and 28.6%, respectively. TM is a highly sensitive and specific marker for acute placental abruption.
Magriples
U
U
Department of Obstetrics and Gynecology, Yale University, New Haven, CT 06510, USA.
Chan
D W
DW
Bruzek
D
D
Copel
J A
JA
Hsu
C D
CD
D000037:Abruptio Placentae / Q000097:blood* / Q000473:pathology; D015415:Biomarkers; D015331:Cohort Studies; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D018180:Thrombomodulin / Q000097:blood*