Coagulation and fibrinolysis in preeclampsia and neonates
Coagulation and fibrinolysis in preeclampsia and neonates
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DOI：
10.1177/107602960501100415
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发表时间：
2005-10-01
影响因子：
2.9
通讯作者：
Koh, SCL
中科院分区：
文献类型：
--
作者：
Tanjung, MT;Siddik, HD;Koh, SCL
在棉兰大学医院分娩的67名印度尼西亚妇女中测定了凝血和纤溶。他们被诊断为在足月妊娠（平均39.3 +/- 1.1周），中度和重度先兆子痫（n=32）和劳动，8早产（妊娠平均33.5 +/- 2.6周）。27例正常分娩孕妇（妊娠平均39.7 ± 1.0周）作为对照。还评估了23名正常妊娠新生儿和31名先兆子痫新生儿的脐带血。先兆子痫妇女在分娩中表现出进一步增强的凝血激活（F1+2），尿激酶样纤溶酶原激活物（u-PA）活性升高，纤溶酶原激活物抑制剂-2（派-2）水平降低。在早产先兆子痫，显着降低抗凝血酶III（ATIII）和派-2水平进一步升高组织型PA（t-PA）抗原和纤溶酶原激活物抑制剂-1（派-1）抗原相比，正常妊娠。这些将表明在早产先兆子痫中凝血酶生成增强，纤维蛋白溶解/抑制蛋白升高的状态。在先兆子痫中观察到的派-2水平降低已被认为与胎盘功能降低相关。足月正常妊娠或先兆子痫母亲所生的新生儿显示出相似的止血变化，与其各自的母体血浆水平相比，纤维蛋白原、ATIII、t-PA、u-PA抗原、派-1水平和凝血活化降低。在两个队列的新生儿之间研究的止血参数没有观察到显著差异，这表明新生儿受到保护，免受先兆子痫的不良影响，并且其止血系统在生理上是平衡的。
Coagulation and fibrinolysis were determined in 67 Indonesian women admitted to the University Hospitals for delivery in Medan. They were diagnosed to be at term gestation (mean 39.3 +/- 1.1 weeks) with moderate and severe preeclampsia (n=32) and in labor, and 8 had preterm labor (gestation mean 33.5 +/- 2.6 weeks). Twenty-seven normal pregnant women in labor (gestation mean 39.7 +/- 1.0 weeks) served as controls. Cord blood from 23 neonates from normal pregnancy and 31 neonates from preeclampsia was also evaluated. Preeclamptic women in labor showed further enhanced coagulation activation (F1+2) with raised urokinase-like plasminogen activator (u-PA) activity and reduced plasminogen activator inhibitor-2 (PAI-2) levels. In preterm preeclampsia, significantly reduced antithrombin III (ATIII) and PAI-2 levels with further elevated tissuetype PA (t-PA) antigen and plasminogen activator inhibitor-1(PAI-1) antigen were seen compared to normal pregnancy. These would suggest a state of enhanced thrombin generation with elevated fibrinolytic/inhibitor proteins in preterm preeclampsia. The reduced PAI-2 levels seen in preeclampsia have been suggested to be associated with reduced placental function. Neonates born to mothers of either normal pregnancy or preeclampsia at term showed similar hemostatic changes with reduced fibrinogen, ATIII, t-PA, u-PA antigen, PAI-1 levels, and coagulation activation compared to their respective maternal plasma levels. No significant differences in hemostatic parameters studied between the neonates of both cohorts were seen, and this would suggest that the neonates were protected from the adverse effects of preeclampsia and their hemostatic system was physiologically balanced.