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The course of preeclampsia(PET) is varied and difficult to predict. Our purpose was to evaluate if thrombomodulin(TM), an endothelial cell surface protein, is elevated in PET and correlates to persistent disease (pPET).
Study design
Thirty-one women being evaluated for PET were studied prospectively. Blood was obtained at initial evaluation, delivery admission, 24 hours (24hr) postpartum (PP), discharge, and 6 weeks PP and stored at −80c. Batch analysis of TM was performed (Immunosorbent assay, Diagnostica Stago). Clinical characteristics, TM results, and perinatal outcomes were evaluated. T-test, ANOVA and regression analyses were performed as appropriate. pPET was diagnosed if hypertension persisted at discharge or PP readmission for PET was needed.
Results
Women with PET delivered earlier than those without (36.7 v 38.9 wks,p = 0.03). No differences in age, gravidity, or race were seen between “no”, “mild”, “severe” PETs, or pPET. TM did not increase with advancing gestational age (p = 0.34). TM was higher inPET at initial evaluation (60.8 vs 41.5), delivery (64.3 vs 38.0), 24 hrPP (50.6 vs 27.5) and discharge (45.0 vs 26.9), p<0.02 each. TM at 24 hrPP and at discharge was higher in pPET vs. No, or non-pPET (figure). Regression analysis revealed TM was not altered by maternal BMI, age, gestational age, parity, race, or creatinine (p>0.2 each). TM levels did not vary with AST, ALT, WBC, HCT, PLT, Uric Acid, 24hr total protein, or protein/creatinine ratio (p>0.2 each).
TM is elevated in PET and remains elevated PP in those with pPET. TM is independent of other laboratory findings. TM may be useful in the diagnosis and evaluation of women with suspected PET.
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