Abstract
Normal pregnancy is a physiological condition of balanced hypercoagulability. However,
in preeclamptic pregnancies, the coagulation and fibrinolytic cascades are highly
activated, accompanied by pathological blood rheology and endothelial dysfunction.
This may result in disseminated intravascular coagulation (DIC). Atherosclerosis research
showed that lipids may interfere with coagulation and cause endothelial dysfunction.
Therefore, we analyzed the lipoprotein distribution and platelet counts in uncomplicated
preeclamptic and HELLP syndrome pregnancies. In addition, a correlation between the
fetal circulation determined by Doppler velocimetry and the maternal lipid metabolism
was investigated. Fasting serum was collected from 24 women in the third trimester
of uncomplicated pregnancies, 9 women with severe preeclampsia, and 6 women with HELLP
syndrome. Cholesterol (CH), triglycerides (TGs), and apolipoproteins were analyzed
in serum and in very-low-density (VLDL), intermediate-density (IDL), low-density (LDL),
and high-density (HDL) lipoproteins separated by ultracentrifugation. Compared with
normal pregnancies, TGs in serum, VLDL, IDL, LDL, and HDL were significantly increased
in preeclampsia; no difference in CH concentrations was observed. During HELLP syndrome,
IDL-TGs were increased compared with normal pregnancies. There was no clear correlation
between fetal hemodynamics and maternal lipid metabolism, but there was a significant
negative correlation between maternal platelet counts and serum TG levels. Because
TG-rich particles may play an important role in thrombin generation and may induce
platelet aggregation, the observed changes in lipoprotein metabolism in preeclampsia
and HELLP syndrome may contribute to the coagulopathy seen in these conditions.
Keywords:
Triglycerides - platelets - Doppler velocimetry - preeclampsia - HELLP syndrome
