Tissue factor levels and high ratio of fibrinopeptide A : D-dimer as a measure of endothelial procoagulant disorder in pre-eclampsia

To assess coagulation activation and endothelial cell injury in normotensiv e and pre-eclamptic pregnant women, a comparision was made of plama levels of tissue factor, fibronectin, fibrinopeptide A and D-dimer. Samples were t aken from 50 nonpregnant women, 40 normotensive pregnant women in the third trimester and 27 women with pre-eclampsia after diagnosis and before treat ment. High levels of fibrinopeptide A and D-dimer were found in pre-eclampt ic women; Moreover, the ratio fibrinopeptide A:D-dimer was much greater in the pre-eclampsia group than in normotensive pregnant women. The levels of fibronectin and tissue factor were also higher in the pre-eclampsia group. The increase of tissue factor levels suggests an alteration of the extrinsi c coagulation pathway in pre-eclampsia. The increase of fibrinopeptide A:D- dimer ratio shows that the activation of coagulation is associated with a r elative hypofibrinolysis in pre-eclampsia.