PLASMA-LEVELS OF VON-WILLEBRAND-FACTOR AND FIBRONECTIN AS MARKERS OF PERSISTING ENDOTHELIAL DAMAGE IN PREECLAMPSIA

Objective: To evaluate the levels of von Willebrand factor and fibrone ctin as markers for the severity of endothelial cell injury in preecla mpsia. Methods: In 63 pregnant women with preeclampsia, the plasma lev els of von Willebrand factor and fibronectin were measured as soon as symptoms were detected, at 5 weeks postpartum, and after lactation. Th ey were also compared with levels in 29 normotensive pregnant women. T he von Willebrand factor was measured by enzyme-linked immunoassay and fibronectin was measured using an automated immunonephelometric metho d. Results: In preeclampsia, the levels of von Willebrand factor and f ibronectin were higher than in normal pregnancy samples drawn in the s econd and third trimesters. The levels of fibronectin were still eleva ted at 5 weeks postpartum in women with severe preeclampsia. Four pati ents with severe preeclampsia who were studied frequently had high lev els of von Willebrand factor 5 weeks postpartum. Conclusions: The incr eased maternal plasma levels of von Willebrand factor and fibronectin indicate that endothelial stimulation is present during preeclampsia. The high fibronectin values found even 5 weeks after delivery, at leas t in patients with severe preeclampsia, may indicate an ongoing vascul ar disease with increased risk for preeclampsia in subsequent pregnanc ies.