STUDY ON COAGULATION AND FIBRINOLYTIC SYSTEMS IN PRE-ECLAMPSIA AND THE SHORT TERM EFFECTS OF METHYLDOPA AND ISRADIPINE ON HAEMOSTATIC MECHANISMS IN PRE-ECLAMPSIA

Abstract

Significantly reduced levels of t-PA activity, u-PA, PAI-2 and antithrombin III with elevated t-PA antigen, fibrinogen and beta-thromboglobulin were seen in preeclampsia compared to normal pregnancy when matched for age and gestation. The reduced plasma u-PA and PAI-2 levels indicate reduced synthesis by the placenta with less available t-PA activity in the circulation. Raised t-PA antigen reflects vascular cell damage. The increased fibrinogen and ?-TG with decreased AT III reflect a more pronounced hypercoagulable state in preeclampsia. The mean PAI-1, TAT-complex and D-dimer levels, although did not deviate from normal pregnancy, were higher than observed in non-pregnant subjects. The antihypertensive drugs, methyldopa and isradipine, a calcium channel blocker agent used in this study did not affect the haemostatic levels studied at 7 and 14 days of treatment. In normal pregnancy, a dynamic equilibrium exists between a hypercoagulable state and enhanced fibrinolytic and inhibitor state. The haemostatic changes seen in pre-eclampsia suggest signs of placental insufficiency and an enhanced thrombotic state of fibrin formation.