ALTERED CIRCULATING THROMBOMODULIN LEVELS AND ANTITHROMBIN-III ACTIVITY AS EVIDENCE FOR VARIED ACTIVATION OF THE COAGULATION CASCADE IN SEVERELY VERSUS MILDLY PREECLAMPTIC PREGNANCIES

Objective: To determine the changes of circulating thrombomodulin leve ls and antithrombin-III activity in the activation of the coagulation cascade between severe and mild preeclampsia, Methods: Twenty women wi th mild preeclampsia and 10 with severe preeclampsia were matched with 30 normotensive healthy pregnant women. Maternal circulating thrombom odulin levels and antithrombin-III activities were measured by enzyme immunoassay and Microlatex particle-mediated immunoassay, respectively , Wilcoxon signed-rank test and conventional correlation coefficient w ere used for statistical analyses. Results: Circulating thrombomodulin levels were significantly higher in severe but not mild preeclamptics as compared with the matched controls, However, antithrombin-III acti vities were significantly lower in both severe and mild preeclampsia. Circulating thrombomodulin levels were inversely correlated with antit hrombin activities in women with severe preeclampsia (r = -0.748, P = 0.01) but not in women with mild preeclampsia. Conclusions: Varied alt erations of thrombomodulin levels and antithrombin-III activity betwee n severe and mild preeclampsia may reflect a different degree of endot helial cell dysfunction in the activation of the coagulation cascade.