A study of coagulation and fibrinolysis abnormalities in preeclamptic patients.

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1. The hypercoagulable state in preeclamptic patients was investigated in comparison with normal pregnant women using new coagulation parameters : AT III, alpha_1 AT, Protein C, Protein C inhibitor(PCI), APC-PCL complex, AI)C- alpha_1 AT complex, Protein S, alpha_2 antiplasmin-plasmin complex(PIC), Thrombin-ATUI complex(TAT), uPA, tPA, PAI-1, PAI-2, Protein C activation peptide(PCP)and D-Dimer FDP. Among these parameters, a significant increase in TAT, PIC, D-Dimer FDP and APC-alpha_1 AT complex was observed, and a decrease in AT]Hantigen was observed in preeclampsia in comparison with normal pregnant-women. This prove hypercoagulabilities in preeclampsia, which might be one of the coagulalioti disorders such as chronic DIC.2. The relationship between clinical symptoms and coagulation abnormalities of preeclampsia was analyzed using of canonical correlation analysis as a multivariate analysis. The indicies obtained from the results, which were called the Clinical Index and the Coagulation Index, had significantly high correlation coefficient r=0.7006 on selected varieties : edema, proteinuria and systolic blood pressure among clinical symptoms and AT III antigen, PIC and D-Dimer FDP among coagulative parameters. These new indicies were considered to be useful to evaluate the clinical severity of preeclampsia and to evaluate the efficacy of treatment.3. Finally the results of present study suggest the possibility of anticoagulants, fibrinolytic agents and platelet aggregation inhibitors on treatment of preeclampsia. Recently we observed therapeutic effectiveness of AT III concentrate as anlicoagulant therapy to severe preeclampsia. As a result, we obtained clinical efficacy of this treatment because of correction of the hypercoagulable state and improvement of clinical symptoms and the fetal condition.