Coagulation/fibrinolysis disorder in patients with severe preeclampsia

We investigated coagulation/fibrinolysis parameters in 50 patients with sev ere preeclampsia. The coagulation and clinical indices in patients with sev ere preeclampsia were 1.595 and 1.414, respectively. These indices show a s trong correlation between the clinical status and coagulation/fibrinolysis abnormalities. Among patients with severe preeclampsia, a significant decre ase in antithrombin (AT) (p = 0.002) and a significant increase in plasmin inhibitor complex (PIC) (p = 0.002), D-dimer (p < 0.05), and thrombin-antit hrombin complex (TAT) (p = 0.001) were observed in cases terminated by cesa rean section compared with those cases of vaginal delivery. There was no si gnificant difference in platelet count (Plt), however, Delta Plt (the diffe rence between platelet counts in early gestation and before delivery) was s ignificantly larger (p < 0.05) in cases that ended in cesarean section. Fur thermore, among cases terminated by cesarean section, a significant increas e in PIC (p < 0.01) was observed when pregnancies were terminated because o f maternal factors compared with those terminated because of fetal factors. These results suggest that (1) even in patients with severe preeclampsia, vaginal deliveries can be successful when they display a less hypercoagulab le state; (2) a decrease in Pit during pregnancy may be a predictive marker for the termination of pregnancy; and (3) an excessive hypercoagulable sta te in patients with severe preeclampsia may be associated with the terminat ion of pregnancy, especially when there is an aggravation of maternal facto rs.