Offer Erez1,2, Roberto Romero1,3,4,5, Edi Vaisbuch1,2, Juan Pedro Kusanovic1,6,7, Shali Mazaki-Tovi1,2, Tinnakorn Chaiworapongsa1,2, Francesca Gotsch1,8, Pooja Mittal1,2, Samuel S Edwin1, Chia-Ling Nhan-Chang9, Nandor Gabor Than1,2,10,11,12, Chong Jai Kim1,13, Sun Kwon Kim1, Lami Yeo1,2, Moshe Mazor14, Sonia S Hassan1,2. 1. a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD , USA. 2. b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA. 3. c Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA. 4. d Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA. 5. e Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA. 6. f Department of Obstetrics and Gynecology, Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF) , Sótero del Río Hospital , Santiago , Chile. 7. g Division of Obstetrics and Gynecology, Faculty of Medicine , Pontificia Universidad Católica de Chile , Santiago , Chile. 8. h Department of Obstetrics and Gynecology , Azienda, Ospedaliera Universitaria Integrata , Verona , Italy. 9. i Department of Obstetrics and Gynecology , Columbia University , New York , NY , USA. 10. j Department of Maternity Private, Kutvolgyi Clinical Block , Semmelweis University , Budapest , Hungary. 11. k Systems Biology of Reproduction, Lendulet Research Group , Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences , Budapest , Hungary. 12. l First Department of Pathology and Experimental Cancer Research , Semmelweis University , Budapest , Hungary. 13. m Department of Pathology , University of Ulsan College of Medicine , Seoul , Republic of Korea. 14. n Department of Obstetrics and Gynecology , Ben-Gurion University , Beer-Sheva , Israel.
Abstract
OBJECTIVE: We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with a small-for-gestational-age (SGA) fetus. METHODS: This cross-sectional study included women in the following groups: (1) normal pregnancy (NP) (n = 49); (2) PE (n = 56); and (3) SGA (n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: (a) lag time (LT); (b) velocity index (VI); (c) peak thrombin concentration (PTC); (d) time-to-peak thrombin concentration (TPTC); and (e) endogenous thrombin potential (ETP). RESULTS: (1) The median TPTC, VI, and ETP differed among the groups (p = .001, p = .006, p < .0001); 2) the median ETP was higher in the PE than in the NP (p < .0001) and SGA (p = .02) groups; 3) patients with SGA had a shorter median TPTC and a higher median VI than the NP (p = .002, p = .012) and PE (p < .0001, p = .006) groups. CONCLUSIONS: (1) Patients with PE had higher in vivo thrombin generation than women with NP and those with an SGA fetus; (2) the difference in TGA patterns between PE and SGA suggests that the latter group had faster TGA, while patients with PE had a longer reaction, generating more thrombin. This observation is important for the identification of a subset of patients who might benefit from low molecular-weight heparin.
OBJECTIVE: We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with a small-for-gestational-age (SGA) fetus. METHODS: This cross-sectional study included women in the following groups: (1) normal pregnancy (NP) (n = 49); (2) PE (n = 56); and (3) SGA (n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: (a) lag time (LT); (b) velocity index (VI); (c) peak thrombin concentration (PTC); (d) time-to-peak thrombin concentration (TPTC); and (e) endogenous thrombin potential (ETP). RESULTS: (1) The median TPTC, VI, and ETP differed among the groups (p = .001, p = .006, p < .0001); 2) the median ETP was higher in the PE than in the NP (p < .0001) and SGA (p = .02) groups; 3) patients with SGA had a shorter median TPTC and a higher median VI than the NP (p = .002, p = .012) and PE (p < .0001, p = .006) groups. CONCLUSIONS: (1) Patients with PE had higher in vivo thrombin generation than women with NP and those with an SGA fetus; (2) the difference in TGA patterns between PE and SGA suggests that the latter group had faster TGA, while patients with PE had a longer reaction, generating more thrombin. This observation is important for the identification of a subset of patients who might benefit from low molecular-weight heparin.
Entities:
Keywords:
Endogenous thrombin potential; fetal growth; hypertension; pregnancy; velocity index
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