Evaluation of some haemostatic markers in normal pregnancies and pregnancies complicated by preeclampsia or eclampsia

ABSTRACT

To establish the plasma evolution of P-selectin, plateletfactor4 [Pf4], prothrombin fragments 1+2 [F1+2], thrombin antithrombin complex [TAT], von Willebrand factor [vWF] and blood platelet count during normal pregnancy, preeclampsia and eclampsia and to determine which are the most relevant and accurate to perform in clinical practice for estimating the severity of preeclampsia. Twenty patients with mild preeclampsia, twenty patients with severe preeclampsia, ten eclamptic cases and ten normotensive pregnant women were included in the study. All cases and controls were with gestational age ranging between 28 and 38 weeks. All five markers increased and platelet count decreased in the severe preeclampsia and eclampsia groups. A highly significant negative correlation was found between platelet count and both P-selectin and Pf4 in the three studied hypertensive groups. Moving from mild to severe preeclampsia to eclampsia, vWF and Pf4 showed an increasingly abnormal results. Pf4 was the only haemostatic marker elevated in the mild preeclampsia group as compared with the normal pregnant group [P=0.000]. [1] Platelet activation may play an important role in the pathogenesis of preeclampsia; [2] Plasma levels of vWF and Pf4 could reflect the severity of this disease, [3] Pf4 appears to be an interesting marker for detecting early alterations in the haemostatic system in pregnancies complicated by preeclampsia. It seems that measurements of haemostatic markers in patients with preeclampsia may have prognostic value in determining the outcome of pregnancy in this pregnancy disorder. They offer possibilities of early assessment of therapeutic approaches aimed at limiting vascular endothelial damage and platelet activation