Alternations of Maternal and Cord Plasma Hemostasis in Preeclampsia Before and After Delivery

Abstract

Objective: The aim of this study was to investigate the role of hemostatic factors in the pathogenesis of preeclampsia. Materials and Methods: Maternal and cord plasma concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI), von willebrand factor (vWF), soluble P-selectin (sP-selectin), fibrinopeptide A (FPA), D-dimer, and antithrombin III (AT-III) were measured by enzyme-linked immunosorbent assay (ELISA) in 46 women with preeclampsia and 40 normotensive pregnant women before and after delivery. Results: The maternal plasma concentrations of TF, vWF, and sP‐selectin were higher, but lower concentrations of TFPI, AT-III, and D-dimer were observed in women with preeclampsia compared to normotensive pregnant women before and after delivery. Compared with maternal plasma, fetal plasma concentrations of TF concentrations were increased significantly in both groups, whereas vWF, FPA, TFPI, AT-III, and D-dimer were decreased. Compared with normotensive pregnancy, fetal plasma concentrations of TF were markedly increased in preeclampsia, accompanied with a higher vWF and a lower sP-selectin and D-dimer levels. Furthermore, fetal plasma TF concentrations were more significantly increased in women with high blood pressure and severe proteinuria. Conclusions: Imbalance in the coagulation/fibrinolysis equilibrium, especially alterations in the extrinsic pathway of coagulation and anticoagulation, may play an important role in the pathogenesis of preeclampsia. In addition, fetal alteration of TF may be involved in the pathogenesis of fetal complications of preeclampsia.

• Coagulation
• Fibrinolysis
• Tissue factor
• Preeclampsia
• Thrombophilia

ACKNOWLEDGMENTS

This work was partly supported by the grants from the Key Project of Chinese National Programs for Fundamental Research and Development (2010CB529504), National Science Fund of China (30872777) and Shanghai Leading Academic Discipline Project (B117). We gratefully acknowledge the technical assistance provided by Dr. Xu Cai, Dr. Hong-Shen Guo, and Dr. De-Sheng Kong.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.