PERTURBED (PROCOAGULANT) ENDOTHELIUM AND DEVIATIONS WITHIN THE FIBRINOLYTIC SYSTEM DURING THE 3RD TRIMESTER OF NORMAL-PREGNANCY - A POSSIBLE LINK TO PLACENTAL FUNCTION

Purpose. To evaluate the endothelial cell state and the possible relat ion to placental function in the third trimester of normal pregnancy b y an indirect assessment of endothelial cell function. Study-design. T wenty-six pregnant women entered the study in the 30th week of pregnan cy. Von Willebrand Factor, urate and key hemostatic variables were qua ntified at entry, and during the 33rd and 37th weeks of pregnancy. Res ults. Levels of von Willebrand Factor, PAI-1 antigen, t-PA antigen; va riables produced by the endothelial cell, increased during the third t rimester of pregnancy. Serum urate, which is correlated with clinical outcome of pregnancy, increased during the study period and correlated directly with von Willebrand Factor and PAI-1 antigen, respectively. There was an inverse correlation between the concentrations of placent a-derived PAI-2 antigen and urate. Conclusions. In healthy human pregn ancy the markers of endothelial related processes of coagulation and f ibrinolysis pointed towards a procoagulatory state of the endothelial cell. However, the balance between fibrin formation and resolution see med to be maintained in uncomplicated pregnancy. Our study indicated a n association between this change of endothelial cell function and pla cental function.