Variation of des-gamma-carboxyprothrombin (PIVKA-II) levels in cord blood throughout gestation

The variation of des-gamma-carboxyprothrombin (PIVKA-II, protein induced by vitamin K absence) levels in umbilical cord blood throughout gestation was examined using a highly sensitive method, electrochemiluminescence immunoa ssay (ECLIA). PIVKA-II levels in infants without any complications were low , but modestly high, exceeding the normal range of healthy adults during th e preterm period, followed by a remarkable increase after the 37th week of gestation. Among infants complicated with severe preeclampsia a marked incr ease of PIVKA-II levels was observed in preterm infants, showing a good cor relation with the existence of infarctions on the placenta. On the other ha nd, among infants complicated with preterm premature rupture of the membran es (PROM) in which antibiotics were administered during the prenatal period , a moderate elevation of PIVKA-II levels was observed. These data suggest that the normal range of PIVKA-II in fetuses is modestly high compared with adults and any deficient status of vitamin K would not exist throughout th e preterm period. Nevertheless, the vitamin K status might readily fall int o a deficient condition in term infants. Furthermore, it is notable that Vi tamin K deficiency would be induced in complicated gestation with severe pr eeclampsia and medication with antibiotics.