ABSTRACT
We investigated coagulation/fibrinolysis parameters for significant differences between
patients with early-onset severe preeclampsia (< 32 weeks gestation, wG) and those
with late-onset severe preeclampsia (≥ 32 wG). A decrease in antithrombin (AT), protein
C (PC), and free protein S (PS) activities and an increase in plasmin-α2-plasmin inhibitor
complex (PIC), thrombin-antithrombin complex (TAT), and FDP D-dimer (D-dimer) were
observed. However, there were no statistical differences between the two groups. Once
preeclampsia occurred and it developed severe, the changes in coagulation/fibrinolysis
parameters became more severe in spite of early-onset preeclampsia or late-onset preeclampsia.
We also investigated coagulation/fibrinolysis abnormalities in 101 patients with severe
preeclampsia. A significant increase in WBC, RBC, Hb, Ht, TAT, PIC, and D-dimer and
a significant decrease in platelet (Plt) counts and AT activity were observed. ΔPlt
(the difference between platelet counts in early gestation and before delivery) was
-5.0 × 10
@affil4:4 /μL in cases with severe preeclampsia. Among patients with severe preeclampsia, coagulation/fibrinolysis
changes before delivery were typical for patients with cesarean section compared with
those with successful vaginal delivery. These facts suggest that an excessive hypercoagulable
state is associated with the termination of pregnancy resulting from the aggravation
of preeclampsia. From the viewpoint of coagulation/fibrinolysis changes, the termination
of pregnancy could be recommended when the levels of parameters exceed the following
values; ΔPlt >| -6.0 | × 10
@affil4:4 /μL, D-dimer > 4 μg/mL, AT activity < 79%, TAT > 26 ng/mL, and PIC > 1.2 μg/mL. Particularly,
ΔPlt and D-dimer are useful bedside predictive markers in order to decide the optimal
time for the termination of pregnancy in patients with severe preeclampsia.
KEYWORD
Preeclampsia - platelet counts - FDP D-dimer - antithrombin - thrombin-antithrombin
complex
