Total and free tissue factor pathway inhibitor in pregnancy hypertension.
OBJECTIVE
To clarify the role played by tissue factor pathway inhibitor (TFPI) in pregnancy hypertension.


METHODS
Using enzyme-linked immunosorbent assays, hemostatic measurements were obtained for women with pre-eclampsia (n=51), nonproteinuric hypertension of pregnancy (n=62), postpartum pre-eclampsia 24 h after childbirth (n=31), and no hypertension (healthy pregnant controls, n=100).


RESULTS
There was a significant increase in circulating free TFPI levels in women with pre-eclampsia (9.7+/-6.2 ng/mL) or nonproteinuric hypertension of pregnancy (8.3+/-5.3 ng/mL) compared with healthy controls (5.3+/-2.1 ng/mL). In women with pre-eclampsia the levels remained elevated after placental delivery (10.6+/-4.0 ng/mL). Free protein S levels were significantly higher in women with pre-eclampsia (40.0%+/-10.7%), nonproteinuric hypertension of pregnancy (37.1%+/-12.5%), or postpartum pre-eclampsia (39.3%+/-9.1%) than in healthy pregnant controls (32.2%+/-8.5%).


CONCLUSIONS
Increased levels of the physiologically active free forms of TFPI and free protein S, 2 coagulation inhibitors, may protect women with pregnancy-induced hypertension from the risks of hemostatic activation.
Abdel Gader
A M
AM
The Coagulation Laboratory, Department of Physiology, College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia. amagader@ksu.edu.sa
Al-Mishari
A A
AA
Awadalla
S A
SA
Buyuomi
N M
NM
Khashoggi
T
T
Al-Hakeem
M
M
D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D020073:Gravidity; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis*; D018455:Protein S Deficiency / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood*
D017395:Plasminogen Activator Inhibitor 1; D011486:Protein C; D010959:Tissue Plasminogen Activator