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293: Thrombin generation in women with preeclampsia

      Objective

      Levels of thrombin generation markers such as prothrombin fragments 1+2 (F 1+2) and thrombinantithrombin complex (TAT) are elevated in women with preeclampsia. We investigated the thrombin generation (TG) by means of calibrated automated thrombography (CAT). The endogenous thrombin potential (ETP) has been shown to correlate with plasma-based hypercoagulable states and the individual′s risk of possibly being affected by thrombosis.

      Study Design

      TG was measured in platelet poor plasma by means of CAT in 17 late onset preeclamptic women (PE) and 80 healthy pregnant women (HP) during III. trimester. In addition, TAT and F1+2 were measured in plasma using commercially available ELISA assays (Enzygnost TAT® and Enzygnost F1+2®, Dade Behring, Marburg, Germany). For comparison of parameters the Mann-Whitney U test was performed. All statistical analyses were performed with SPSS©, software (SPSS Inc., Chicago, Illinois, USA).

      Results

      ETP was significantly higher in preeclamptic women when compared to controls. The time until the thrombin peak was reached (TTP) was significantly prolonged in preeclamptic women, while no significant difference was found for the thrombin peak (p=0.157) or lag time (p=0.446). F1+2 and TAT were significantly higher in preeclamptic women when compared to controls (p=0.0001).

      Conclusion

      These data show that preeclamptic women generate significantly higher amounts of thrombin and that the time until the thrombin concentration approaches zero is significantly elongated in comparison to women with uncomplicated pregnancies. In addition, F1+2 and TAT were significantly higher in preeclamptic women, which is in accordance with previous studies on coagulation in preeclamptic pregnancies and representing an increased activity of the coagulation system. Our study demonstrates that ETP values are higher in preeclamptic women when compared to normal controls. These results suggest that it might be worthwhile to investigate, whether an increased ETP in early pregnancy is predictive for the development of future preeclampsia.