Thromb Haemost 1998; 79(06): 1092-1095
DOI: 10.1055/s-0037-1615021
Rapid Communication
Schattauer GmbH

Predictive Value of Plasma Thrombomodulin in Preeclampsia and Gestational Hypertension

Marie-Claire Boffa
1   From the INSERM Unité 353, Hôpital Saint-Louis, Paris, France
,
Luca Valsecchi
2   From the Cattedra di Ostetricia e Ginecologia, Milano, Italy
,
Alfonso Fausto
2   From the Cattedra di Ostetricia e Ginecologia, Milano, Italy
,
Danielle Gozin
1   From the INSERM Unité 353, Hôpital Saint-Louis, Paris, France
,
Silvana Vigano’ D’Angelo
3   From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy
,
Omid Safa
3   From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy
,
Maria Teresa Castiglioni
2   From the Cattedra di Ostetricia e Ginecologia, Milano, Italy
,
Jean Amiral
4   From the Serbio, Gennevilliers, France
,
Armando D’Angelo
3   From the Servizio di Coagulazione, Istituto Scientifico H S. Raffaele, Milano, Italy
› Author Affiliations
Further Information

Publication History

Received 16 July 1997

Accepted after resubmission 04 February 1998

Publication Date:
07 December 2017 (online)

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Summary

In a prospective longitudinal study, 130 primigravidae at risk for preeclampsia were examined and plasma sampling performed in 45 of them. Plasma thrombomodulin (pTM) was sequentially measured at weeks 12, 24 and 32 of gestation and after delivery in 20 primigravidae who developed either mild preeclampsia (n = 8) or gestational hyper-tension (n = 12) between weeks 32 and 39 of gestation and in 25 (age-matched) primigravidae who had uneventful pregnancies. pTM elevations were not observed until week 32 in uneventful pregnancies, but were present by week 24 (p = 0.002) in patients who later developed hypertensive complications. A net individual pTM increase ≥4.2 ng/ml between weeks 12 and 24 (more than 8 times that of normotensive primigravidae) and/or pTM level ≥47.5 ng/ml at week 32 predicted the development of hypertensive complications with 80% accuracy. Serial pTM determinations can be useful to select pregnancies who may benefit from early pharmacological intervention.