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Coagulation Predicts Pre-Eclampsia Risk

Excessive coagulation is associated with aggravated pre-eclampsia and an index based on coagulation can distinguish severe pre-eclampsia from normal pregnancy.

Researchers from Hamamatsu University, Japan, examined 72 normal pregnancies during the third trimester and 56 pregnancies that showed severe pre-eclampsia. The authors measured the difference between platelet counts in early gestation and before delivery. They also measured antithrombin (AT) activity, thrombin-antithrombin (TAT) complex and fibrin degradation products (FDP) D-dimer. Based on multivariate logistic regression analysis, the authors derived a coagulation index.

The average coagulation index was -0.77 during normal pregnancy and 1.41 in those that showed severe pre-eclampsia. This difference was highly significant. Furthermore, coagulation and fibrinolysis disorders before delivery were "typical" among patients with severe pre-eclampsia terminated by caesarean section compared to vaginal delivery. The coagulation indices were 1.62 and 0.52 respectively. The coagulation index's predictive value for deciding the best time for termination given the risk of coagulation and fibrinolysis disorders was over 1.20.

The authors concluded that excessive coagulation is associated with an increased risk of caesarean section due to aggravated pre-eclampsia.
Semin Thromb Hemost 2002;28:6:495-500. "Coagulation index to distinguish severe preeclampsia from normal pregnancy."

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