title: Placental vascular pathology and increased thrombin generation as mechanisms of disease in obstetrical syndromes.
abstract: Obstetrical complications including preeclampsia, fetal growth restriction, preterm labor, preterm prelabor rupture of membranes and fetal demise are all the clinical endpoint of several underlying mechanisms (i.e., infection, inflammation, thrombosis, endocrine disorder, immunologic rejection, genetic, and environmental), therefore, they may be regarded as syndromes. Placental vascular pathology and increased thrombin generation were reported in all of these obstetrical syndromes. Moreover, elevated concentrations of thrombin-anti thrombin III complexes and changes in the coagulation as well as anticoagulation factors can be detected in the maternal circulation prior to the clinical development of the disease in some of these syndromes. In this review, we will assess the changes in the hemostatic system during normal and complicated pregnancy in maternal blood, maternal-fetal interface and amniotic fluid, and describe the contribution of thrombosis and vascular pathology to the development of the great obstetrical syndromes.
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera-Universitaria Policlinico di Bari, School of Medicine, University of Bari "Aldo Moro" , Bari , Italy ; Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Salvatore Andrea
authors.initials: SA
authors.lastname: Mastrolia
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera-Universitaria Policlinico di Bari, School of Medicine, University of Bari "Aldo Moro" , Bari , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Loverro
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Klaitman
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
keywords: Amniotic fluid; Coagulation; Fetal demise; IUGR; PROM; Preeclampsia; Preterm labor; Protein Z; TAT III complexes; TFPI