DECREASE IN PLASMINOGEN-ACTIVATOR INHIBITOR TYPE-2 RELATED MORE TO PLACENTAL FUNCTION AND INTRAUTERINE FETAL GROWTH THAN TO SEVERITY OF PREECLAMPSIA

Objectives: To evaluate changes in levels of plasminogen activator inh ibitor type 2 (PAI-2) during preeclamptic pregnancies. To assess wheth er the changes are related to placental and/or fetal complications, an d to the severity of preeclampsia. Methods: Concentrations of plasma P AI-2 were measured in 21 normal pregnant women, 94 preeclamptic patien ts, and 2 patients with hydatidiform mole. Comparisons were made betwe en the respective groups. Results: Significantly higher PAI-2 levels w ere shown in the pregnant women with or without preeclampsia than in h ealthy nonpregnant subjects (P < 0.01), but the preeclamptic patients had lower levels than the normal pregnant women (P < 0.01). In the pat ients with placental infarction, intrauterine fetal asphyxia, and intr auterine fetal growth retardation, PAI-2 levels were significantly dec reased (P < 0.01). However, no difference was present between patients with mild or severe preeclampsia (P > 0.05). In the patients with mol ar disease, no PAI-2 antigen was detected. Conclusion: Plasma PAI-2 le vels are more closely related to placental function and fetal growth t han to the severity of preeclampsia. Presence of fetal tissues and the ir healthy state seem to share responsibility with the quantity and qu ality of placental tissues for regulating plasma PAI-2 levels. A marke d reduction in PAI-2 concentration may suggest a high risk of placenta l and/or fetal complications during preeclamptic pregnancy.