The pattern and magnitude of "in vivo thrombin generation" differ in women with preeclampsia and in those with SGA fetuses without preeclampsia. (3rd July 2018)

• Record Type: Journal Article
• Authors: Erez, Offer; Romero, Roberto; Vaisbuch, Edi; Kusanovic, Juan Pedro; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Edwin, Samuel S.; Nhan-Chang, Chia-Ling; Than, Nandor Gabor; Kim, Chong Jai; Kim, Sun Kwon; Yeo, Lami; Mazor, Moshe; Hassan, Sonia S.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 13(2018)
• Page Start: 1671
• Page End: 1680
• Publication Date: 2018-07-03
• Subjects: Endogenous thrombin potential -- fetal growth -- hypertension -- pregnancy -- velocity index; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1323327
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with a small-for-gestational-age (SGA) fetus. Methods: This cross-sectional study included women in the following groups: (1) normal pregnancy (NP) ( n = 49); (2) PE ( n = 56); and (3) SGA ( n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: (a) lag time (LT); (b) velocity index (VI); (c) peak thrombin concentration (PTC); (d) time-to-peak thrombin concentration (TPTC); and (e) endogenous thrombin potential (ETP). Results: (1) The median TPTC, VI, and ETP differed among the groups ( p = .001, p = .006, p < .0001); 2) the median ETP was higher in the PE than in the NP ( p < .0001) and SGA ( p = .02) groups; 3) patients with SGA had a shorter median TPTC and a higher median VI than the NP ( p = .002, p = .012) and PE ( p < .0001, p = .006) groups. Conclusions: (1) Patients with PE had higher in vivo thrombin generation than women with NP and those with an SGA fetus; (2) the difference in TGA patterns between PE and SGA suggests that the latter group had faster TGA, while patients with PE had a longer reaction, generating more thrombin. This observation is important for the identification of a subset of patients who might benefit from low molecular-weight heparin.