title: The role of fibrinolytic and antifibrinolytic activities in the pathophysiology of HELLP syndrome.
abstract: OBJECTIVE
  To determine the role of the fibrinolytic and antifibrinolytic systems in HELLP syndrome.
  
  
  METHODS
  This study consisted of patients with HELLP Syndrome (study group, n = 17), women who were admitted for routine prenatal care (pregnant control group, n = 21) and those presenting for routine gynecologic examination (non-pregnant control group, n = 21). Plasma tissue-type plasminogen activator (tPA), thrombin-activatable fibrinolysis inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1), thrombin-antithrombin complex (TAT) and thrombomodulin (TM) were measured at admission for all groups. They were again measured after 7 days of biochemical improvement in HELLP Syndrome group.
  
  
  RESULTS
  The mean ages of women in the study, pregnant, and non-pregnant control groups were 29.82 ± 4.98, 29.71 ± 5.64, and 27.60 ± 4.21, respectively. Demographically, the patients in all three groups were similar with regard to maternal age, race, and body mass index. Compared to the control groups, the mean tPA, PAI-1, TAFI, TAT, and TM levels were significantly increased in HELLP Syndrome. The mean plasma TAFI antigen concentration 7 days after delivery was significantly lower compared to the baseline (5.84 ± 7.14 % change, p < 0.01). Significant decreases in the mean plasma concentrations were also found in tPA (21.78 ± 20.93 ng/mL mean difference, p < 0.01), PAI-1 (14.22 ± 10.38 ng/mL mean difference, p < 0.001), TAT (0.93 ± 1.19 ng/mL mean difference, p < 0.01), and TM (0.54 ± 0.94 ng/mL mean difference, p < 0.05).
  
  
  CONCLUSIONS
  It is likely that the impaired fibrinolytic and antifibrinolytic systems, in response to thrombus formation, affect the pathophysiology of HELLP syndrome.
authors: Department of Obstetric and Gynecology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. drsuleymanguven@yahoo.com
authors: Suleyman
authors: S
authors: Guven
authors: Mehmet
authors: M
authors: Sonmez
authors: S Caner
authors: SC
authors: Karahan
mesh_terms: D000328:Adult; D000990:Antithrombin III; D015992:Body Mass Index; D025901:Carboxypeptidase B2 / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000209:etiology*; D006801:Humans; D008423:Maternal Age; D010447:Peptide Hydrolases / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D018180:Thrombomodulin / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D018180:Thrombomodulin; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D025901:Carboxypeptidase B2; D010959:Tissue Plasminogen Activator