FETAL FIBRONECTIN LEVELS ARE ELEVATED IN MATERNAL PLASMA AND AMNIOTIC-FLUID OF PATIENTS WITH SEVERE PREECLAMPSIA

OBJECTIVE: Our purpose was to investigate levels of fetal fibronectin in maternal plasma, amniotic fluid, and umbilical cord plasma from pat ients with severe preeclampsia. STUDY DESIGN: The study group comprise d 20 patients with severe preeclampsia (group A). An antepartum compar ison group was composed of 20 healthy patients matched for gestational age (group B). An intrapartum control group consisted of 20 term norm otensive patients (group C). Maternal plasma samples were collected be fore labor (groups A and B), then immediately after delivery and again at 20 to 24 hours post partum (groups A and C). Amniotic fluid was al so collected in early labor, and umbilical cord blood was collected at delivery (groups A and C). Samples were assayed for fetal fibronectin by a specific enzyme-linked immunoassay. RESULTS: Before labor matern al plasma levels of fetal fibronectin were significantly elevated in p reeclamptic patients compared with patients in group B (p < 0.0001). P lasma levels of fetal fibronectin were also increased in preeclamptic patients compared with patients in group C at delivery (p < 0.0001) an d post partum (p < 0.05). Additionally, amniotic fluid levels of fetal fibronectin in the preeclamptic patients were significantly increased (p < 0.05). In contrast, umbilical cord plasma fetal fibronectin conc entrations from the preeclamptic and control patients were similar. CO NCLUSIONS: Fetal fibronectin is elevated in the maternal plasma and am niotic fluid, but not umbilical cord plasma, of patients with severe p reeclampsia. These findings suggest an increase in production of fetal fibronectin from chorionic trophoblast in patients with preeclampsia or an abnormal interaction between chorionic trophoblast and decidua w ith resultant increased leakage into the maternal circulation and amni otic fluid.