Complexes of activated protein C with alpha 1-antitrypsin in normal pregnancy and in severe preeclampsia

Article Abstract:

Pregnancy is associated with changes in hemostasis, or the processes involved in the cessation of bleeding. Certain complications of pregnancy, such as preeclampsia, increase the already enhanced coagulation condition of pregnancy (that is, the likelihood of clotting during pregnancy). Preeclampsia is a toxic condition of pregnancy characterized by increasing hypertension (high blood pressure), headaches, protein in the urine, and edema (fluid accumulation) in the extremities. This hypertensive disorder has also been associated with increased levels of coagulation (blood clotting) factors, and decreased fibrinolysis (breakdown of fibrin, the basic structure of blood clots). Activated protein C and protein S are factors that exert an anticoagulant effect by stopping the processes involved in clotting. Activated protein C is inhibited by protein C inhibitor and alpha 1-antitrypsin. Inherited protein C deficiency results in severe and widespread thrombosis (blood clot formation) in the newborn. Changes in the protein C-activated processes that prevent blood clotting may contribute to coagulation disorders in pregnancy. Levels of protein C and protein S are decreased in patients with severe preeclampsia. Levels of complexes of activated protein C and its two inhibitors were measured in patients with normal pregnancies and patients with severe preeclampsia. The levels of activated protein C/alpha 1-antitrypsin complexes and alpha 1-antitrypsin increased with time in normal pregnancies. However, women with severe preeclampsia had greater levels of protein C/alpha1-antitrypsin and lower levels of protein C and protein C inhibitor than women with normal pregnancies. These changes were not observed in women with chronic hypertension with superimposed severe preeclampsia. The findings show that protein C activity is increased in pregnancy; they are consistent with an increase in the production of the blood coagulation enzyme thrombin in severe preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Measurement, Blood coagulation factors, Pregnancy, Complications of, Pregnancy complications, Protein C, Predictive value of tests, Predictive value of tests (Medical), Alpha 1-antitrypsin

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Fibrinolytic parameters in normotensive pregnancy with intrauterine fetal growth retardation and in severe preeclampsia

Article Abstract:

Intrauterine fetal growth retardation (IUGR), in which fetal growth is abnormally low, can occur in both normotensive pregnancies (i.e. those in which blood pressure remains within the normal range) and those complicated by preeclampsia (a condition of pregnancy involving high blood pressure). It more commonly occurs in the latter. Fetal or infant deaths are more likely when pregnancies are complicated by IUGR. Abnormalities in the blood vessels of the placenta have been noted in IUGR-complicated pregnancies. Fibrinolysis, which is the breakdown of fibrin, a component involved in blood clotting, is counteracted by plasminogen activator inhibitor activity. Increases in plasminogen activator inhibitor levels and concomitant decreases in fibrinolytic activity have been reported in normal pregnancy. Plasminogen activator inhibitors type 1 and 2 are released by the placenta. Abnormal activity of these substances could be responsible for placental damage, which could lead to IUGR. Plasminogen activator inhibitor activity was examined in normal pregnancies and in both normal and preeclamptic pregnancies complicated by IUGR. Blood samples were obtained and analyzed from 18 normal pregnant women with no complications, 16 with preeclampsia (of whom 10 had IUGR), and 11 who were normotensive and had IUGR. The preeclamptic women with IUGR tended to deliver earlier than the women in the other groups, and two infant deaths occurred in this group. Plasminogen activator inhibitor type 1 antigen and activity levels were significantly higher among those with preeclampsia groups and did not differ between the two normotensive groups. Pregnant women with IUGR, with or without preeclampsia, had significantly decreased plasminogen activator inhibitor type 2 levels compared with women with or without preeclampsia that did not have IUGR. These results indicate that decreased levels of plasminogen activator type 2 may be associated with IUGR occurring during pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Fetus, Fetal growth retardation, Preeclampsia, Plasminogen activators, Fibrinolytic agents

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The effect of estrogen replacement therapy with or without progestogen on the fibrinolytic system and coagulation inhibitors in postmenopausal status

Article Abstract:

Estrogen replacement therapy appears to boost the body's fibrinolytic system. This could lower a postmenopausal woman's risk of developing coronary artery disease because the fibrinolytic system is responsible for breaking down blood clots. Researchers measured the activity of the fibrinolytic system in blood samples taken from 75 postmenopausal women taking estrogen replacement therapy and 29 healthy premenopausal women. Fibrinolytic activity was increased in the women taking estrogen replacement therapy compared to the premenopausal women, as measured by an increase in tissue plasminogen activator (tPA) and a decrease in plasminogen activator inhibitor-1 (PAI-1). Their blood samples also contained less lipoprotein(a) than samples from the premenopausal women. Lipoprotein(a) is believed to inhibit fibrinolysis because it resembles plasminogen.

Health aspects, Hormone therapy, Estrogen, Estrogens

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