Correlation between placental bed biopsy findings, vascular cell adhesion molecule and fibronectin levels in pre-eclampsia

Objective To determine the correlation between placental bed biopsy finding s, and blood levels of the vascular cell adhesion molecule (VCAM-1) and fib ronectin in pre-eclampsia/eclampsia, and to evaluate the relationship betwe en these variables and severity of the disease. Design A prospective case-control study. Setting Department of Obstetrics and Gynaecology. Cerrahpasa Medical Facult y, Istanbul. Sample Thirty-five women with pre-eclampsia/eclampsia were compared with 25 healthy women with uncomplicated pregnancies. Twenty-one placental bed bio psies from pre-eclamptic pregnancies were compared with 17 from normal preg nancies. Main outcome measures Peripheral venous blood levels of VCAM-1 and fibronec tin, measured by enzyme-linked immunoassay and radial immune diffusion tech nique. Results In pre-eclampsia/eclampsia, blood VCAM-1 and fibronectin levels wer e higher than in normal pregnancy. Levels of both fibronectin and VCAM-1 co rrelated significantly with the diastolic blood pressure (r = 0.49 and r = 0.65, P < 0.001). There was also a significant direct linear correlation be tween plasma fibronectin and VCAM-1 levels (r = 0.57, P < 0.001). Normotens ive women all had normal placental bed biopsy findings and the incidence of pathological placental bed biopsy findings increased with the severity of the pre-eclampsia. Conclusion Inadequate trophoblastic invasion of spiral arteries, and elevat ed levels VCAM-1 and fibronectin were found in women with pre-eclampsia. Th e magnitude of defective trophoblastic invasion, and blood levels of VCAM-1 and fibronectin correlate with the clinical severity of pre-eclampsia.