Evidence of in vivo generation of thrombin in patients with small-for-gestational-age fetuses and pre-eclampsia
Article
Chaiworapongsa, T, Yoshimatsu, J, Espinoza, J et al. (2002). Evidence of in vivo generation of thrombin in patients with small-for-gestational-age fetuses and pre-eclampsia
. Journal of Maternal-Fetal and Neonatal Medicine, 11(6), 362-367. 10.1080/jmf.11.6.362.367
Chaiworapongsa, T, Yoshimatsu, J, Espinoza, J et al. (2002). Evidence of in vivo generation of thrombin in patients with small-for-gestational-age fetuses and pre-eclampsia
. Journal of Maternal-Fetal and Neonatal Medicine, 11(6), 362-367. 10.1080/jmf.11.6.362.367
Chaiworapongsa, T; Yoshimatsu, J; Espinoza, J; Kim, YM; Berman, S; Edwin, S; Yoon, BH; Romero, R
abstract
Objective: Thrombotic lesions in the maternal or fetal compartments are frequently observed in the placentas of patients with small-for-gestational-age (SGA) fetuses and in pre-eclampsia. The objective of this study was to determine whether there was evidence of in vivo generation of thrombin, the rate-limiting enzyme responsible for the formation of fibrin. The plasma concentrations of thrombin-antithrombin (TAT) complexes were used as an index of thrombin generation. Methods: TAT complexes were measured in the plasma from 68 women from the following groups: normal pregnancy (n = 29); pre-eclampsia (n = 26); and SGA (defined as estimated fetal weight below the 10th centile for gestational age, which was confirmed by neonatal birth weight) (n = 13). TAT complex plasma concentrations were determined with a specific and sensitive immunoassay. Statistical analysis was performed with non-parametric statistics. Results: The median plasma TAT complex concentrations were significantly higher in patients who delivered SGA neonates than in normal pregnant women (SGA, median 24.2 μg/l; range 11.9-788.7 vs. normal pregnancy, median: 14.4 μg/l; range 6.8-26.9; p = 0.001). Patients with pre-eclampsia had a higher median plasma TAT complex concentration than normal pregnant women (pre-eclampsia, median 18.1 μg/l; range 10.0-75.2 vs. normal pregnancy, median 14.4 μg/l; range 6.8-26.9; p = 0.02). Conclusion: In vivo generation of thrombin, determined by the plasma concentrations of TAT complexes, is higher in patients with SGA fetuses and patients with pre-eclampsia than in normal pregnancy.
