Coagulation and fibrinolysis parameters in normal and in hypertensive pregnancies

Objective: To evaluate the plasma levels of coagulation and fibrinolysis parameters in the third trimester of gestation and on the third day after delivery. Methods: Normal pregnant women (n = 65), pregnant women with essential hypertension (n = 10), pregnant women with gestational hypertension without proteinuria (n = 13), and pregnant women with preeclampsia (n = 12) formed the study population. Coagulation and fibrinolysis parameters were estimated using commercial tests. Antithrombin III, thrombin-antithrombin III complexes, heparin cofactor II (HCII), protein C, protein S, tissue plasminogen activator, D-dimer, and plasminogen activator inhibitors levels in uncomplicated pregnancies and in hypertensive pregnancies were determined. Results: No differences were found in coagulation inhibitor levels between normal, chronic essential hypertension, and gestational hypertension groups. However, preeclamptic women showed lower levels of antithrombin III and heparin cofactor II. The concentration of thrombin-antithrombin III was higher in hypertensive disorders, mainly in preeclampsia, than in normal pregnancy. No differences were found in the levels of tissue plasminogen activator and plasminogen activator inhibitors type 1 and type 2 in the normal pregnancy, chronic essential hypertension, and gestational hypertension groups. However, preeclamptic women had higher tissue plasminogen activator and lower plasminogen activator inhibitor type 2 levels. Conclusion: The finding that HCII levels were decreased only in the preeclamptic group shows its potential utility in the diagnosis of preeclampsia.