ALTERED CIRCULATING THROMBOMODULIN AND FIBRONECTIN LEVELS AS EVIDENCEFOR DIFFERENT DEGREES OF VASCULAR ENDOTHELIAL DAMAGE BETWEEN SEVERE AND MILD PREECLAMPSIA

Objective: The purpose of this study is to determine the severity of d isease in preeclamptic pregnancies with two circulating endothelial fa ctors, thrombomodulin and fibronectin. Methods: Sixty women with singl eton pregnancies in the third trimester were studied. Twenty with mild preeclampsia and 10 with severe preeclampsia were matched with 30 nor motensive pregnant women. Maternal serum thrombomodulin and fibronecti n levels were measured by enzyme immunoassay and microlatex particle-m ediated immunoassay. Results: Serum fibronectin levels were significan tly higher in both severely and mildly preeclamptic women than the mat ched controls (P < 0.0005). However, serum thrombomodulin levels were only elevated in severely (P < 0.005), but not in mildly preeclamptic groups. Moreover, there was no significant correlation between serum t hrombomodulin and fibronectin levels in preeclamptic pregnancies (r = 0.3686, P > 0.05). Conclusions: Elevated serum thrombomodulin and fibr onectin levels in pregnant women with preeclampsia provide evidence fo r the endothelial cell dysfunction in the pathological changes occurri ng in preeclamptic pregnancies. Circulating thrombomodulin levels may serve as a better marker in differentiating the severity of disease in preeclamptic pregnancies.