Abstract

BACKGROUND/AIM: Placental syndromes (PS) are characterized by endothelial dysfunction complicating placental dysfunction. Possible markers for endothelial dysfunction and amount of trophoblast are fibronectin and plasminogen activator inhibitor-2 (PAI-2), respectively. We aimed (1) to determine whether in women with recurrent PS (rPS), this complication is preceded by deviating fibronectin- and PAI-2-levels, and (2) whether this is dependent on pre-pregnant plasma volume (PV).

METHODS: In 36 former patients, we determined fibronectin- and PAI-2-levels in blood-samples collected preconceptionally and at 12-16 weeks in their next pregnancy. Differences were analyzed between pregnancies with rPS (n = 12) and without rPS (non-rPS, n = 24) using linear mixed models, with subanalyses based on pre-pregnant normal or subnormal PV.

RESULTS: We observed higher fibronectin-levels at 12-16 weeks (p < 0.05 and p < 0.01, respectively) and lower PAI-2-levels at 16 weeks (p < 0.01) in the rPS subgroup, the intergroup differences being larger in women with subnormal PV.

CONCLUSION: We showed that former PS patients who developed rPS have raised fibronectin- and reduced PAI-2-levels already in early/mid pregnancy. These deviations are even more prominent in women with subnormal pre-pregnant PV, supporting development of a 2-step screening program for former patients to identify the high-risk subgroup of women who may benefit from closer surveillance.

Original languageEnglish
Pages (from-to)355-360
Number of pages6
JournalGynecologic and Obstetric Investigation
Volume82
Issue number4
DOIs
Publication statusPublished - 2017

Keywords

  • Journal Article
  • HYPERTENSIVE DISORDERS
  • ENDOTHELIAL DYSFUNCTION
  • Gestational hypertension
  • MARKERS
  • RISK
  • Fibronectin
  • ARTERY DOPPLER VELOCIMETRY
  • PREGNANCY
  • PATHOPHYSIOLOGY
  • Preeclampsia
  • PAI-2
  • FORMERLY PREECLAMPTIC WOMEN
  • PLASMA FIBRONECTIN
  • Placental syndrome
  • HISTORY

Cite this