Predictive Value of Plasma Thrombomodulin in Preeclampsia and Gestational Hypertension

Marie-Claire Boffa; Luca Valsecchi; Alfonso Fausto; Danielle Gozin; Silvana Vigano’ D’Angelo; Omid Safa; Maria Teresa Castiglioni; Jean Amiral; Armando D’Angelo

doi:10.1055/s-0037-1615021

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 79(06): 1092-1095
DOI: 10.1055/s-0037-1615021

Rapid Communication

Schattauer GmbH

Predictive Value of Plasma Thrombomodulin in Preeclampsia and Gestational Hypertension

Marie-Claire Boffa

¹From the INSERM Unité 353, Hôpital Saint-Louis, Paris, France

,

Luca Valsecchi

²From the Cattedra di Ostetricia e Ginecologia, Milano, Italy

,

Alfonso Fausto

²From the Cattedra di Ostetricia e Ginecologia, Milano, Italy

,

Danielle Gozin

¹From the INSERM Unité 353, Hôpital Saint-Louis, Paris, France

,

Silvana Vigano’ D’Angelo

³From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy

,

Omid Safa

³From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy

,

Maria Teresa Castiglioni

²From the Cattedra di Ostetricia e Ginecologia, Milano, Italy

,

Jean Amiral

⁴From the Serbio, Gennevilliers, France

,

Armando D’Angelo

³From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy

› Author Affiliations

Abstract

Summary

In a prospective longitudinal study, 130 primigravidae at risk for preeclampsia were examined and plasma sampling performed in 45 of them. Plasma thrombomodulin (pTM) was sequentially measured at weeks 12, 24 and 32 of gestation and after delivery in 20 primigravidae who developed either mild preeclampsia (n = 8) or gestational hyper-tension (n = 12) between weeks 32 and 39 of gestation and in 25 (age-matched) primigravidae who had uneventful pregnancies. pTM elevations were not observed until week 32 in uneventful pregnancies, but were present by week 24 (p = 0.002) in patients who later developed hypertensive complications. A net individual pTM increase ≥4.2 ng/ml between weeks 12 and 24 (more than 8 times that of normotensive primigravidae) and/or pTM level ≥47.5 ng/ml at week 32 predicted the development of hypertensive complications with 80% accuracy. Serial pTM determinations can be useful to select pregnancies who may benefit from early pharmacological intervention.

Full Text

References

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