L Deng1, K Bremme, L O Hansson, M Blombäck. 1. Division of Obstetrics and Gynecology, Karolinska Hospital/Karolinska Institute, Stockholm, Sweden.
Abstract
OBJECTIVE: To evaluate the levels of von Willebrand factor and fibronectin as markers for the severity of endothelial cell injury in preeclampsia. METHODS: In 63 pregnant women with preeclampsia, the plasma levels of von Willebrand factor and fibronectin were measured as soon as symptoms were detected, at 5 weeks postpartum, and after lactation. They were also compared with levels in 29 normotensive pregnant women. The von Willebrand factor was measured by enzyme-linked immunoassay and fibronectin was measured using an automated immunonephelometric method. RESULTS: In preeclampsia, the levels of von Willebrand factor and fibronectin were higher than in normal pregnancy samples drawn in the second and third trimesters. The levels of fibronectin were still elevated at 5 weeks postpartum in women with severe preeclampsia. Four patients with severe preeclampsia who were studied frequently had high levels of von Willebrand factor 5 weeks postpartum. CONCLUSIONS: The increased maternal plasma levels of von Willebrand factor and fibronectin indicate that endothelial stimulation is present during preeclampsia. The high fibronectin values found even 5 weeks after delivery, at least in patients with severe preeclampsia, may indicate an ongoing vascular disease with increased risk for preeclampsia in subsequent pregnancies.
OBJECTIVE: To evaluate the levels of von Willebrand factor and fibronectin as markers for the severity of endothelial cell injury in preeclampsia. METHODS: In 63 pregnant women with preeclampsia, the plasma levels of von Willebrand factor and fibronectin were measured as soon as symptoms were detected, at 5 weeks postpartum, and after lactation. They were also compared with levels in 29 normotensive pregnant women. The von Willebrand factor was measured by enzyme-linked immunoassay and fibronectin was measured using an automated immunonephelometric method. RESULTS: In preeclampsia, the levels of von Willebrand factor and fibronectin were higher than in normal pregnancy samples drawn in the second and third trimesters. The levels of fibronectin were still elevated at 5 weeks postpartum in women with severe preeclampsia. Four patients with severe preeclampsia who were studied frequently had high levels of von Willebrand factor 5 weeks postpartum. CONCLUSIONS: The increased maternal plasma levels of von Willebrand factor and fibronectin indicate that endothelial stimulation is present during preeclampsia. The high fibronectin values found even 5 weeks after delivery, at least in patients with severe preeclampsia, may indicate an ongoing vascular disease with increased risk for preeclampsia in subsequent pregnancies.