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Semin Thromb Hemost 2011; 37(2): 125-130
DOI: 10.1055/s-0030-1270338
© Thieme Medical Publishers

Tissue Factor Dependent Pathway and the Diagnosis of Pre-Eclampsia

Bashir A. Lwaleed1 , Luci Dusse2 , Alan J. Cooper3
  • 1Department of Urology, Southampton University Hospitals NHS Trust and School of Health Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
  • 2Department of Clinical and Toxicological Analysis, Federal University of Minas Gerais, Brazil
  • 3Department of Biomedical Sciences, Portsmouth University, Portsmouth, United Kingdom
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Publication History

Publication Date:
02 March 2011 (online)

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ABSTRACT

Pre-eclampsia (P-EC) is a major contributor to perinatal and maternal morbidity and mortality worldwide. Its etiology and pathogenesis remains poorly understood, and differential diagnosis is problematic. During a normal pregnancy, coagulation activation is essential for physiological placental hemostasis, but women with P-EC tend to be more hypercoagulable than normal pregnant women. A common proposed mechanism for P-EC is utero-placental thrombosis. Indeed, multiple placental microthrombi are frequently observed in women with P-EC, and these may compromise placental perfusion and fetal development. This suggests that predisposing factors to thrombosis could contribute to the development of P-EC. Thus studying circulating hemostatic proteins may help elucidate some of the pathogenesis of P-EC and may provide a rational basis for its differential diagnosis and effective treatment. Preliminary studies by our group on third-trimester women suggest that raised circulating factor VII (FVII) is a selective marker for P-EC when women with P-EC were compared with healthy nonpregnant or normal pregnant women groups. Plasma FVII levels have shown good sensitivity and specificity for P-EC of 90% and 80%, respectively. However, significant comparable changes in the other tissue factor (TF)-dependent pathway factors (activated FVII), TF, and tissue factor pathway inhibitor were not observed. Thus we propose the use of plasma FVII as a potential marker of P-EC.

KEYWORDS

Coagulation - FVII - FVIIa - TF - TFPI - pre-eclampsia

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Bashir A LwaleedPh.D. F.R.C.Path. 

Department of Urology, Southampton University Hospitals NHS Trust and School of Health Sciences

University of Southampton, South Academic and Pathology Block (MP 11), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK

Email: bashir@soton.ac.uk

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