Fibrinolytic system in preeclampsia

Preeclampsia (PE) is a multi-system disorder of human pregnancy characterized by hypertension and proteinuria. Although its pathogenesis is not fully understood, predisposition to endothelial dysfunction is thought to play a crucial part. Normotensive pregnancy is associated with increases in coagul...

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Bibliographic Details
Published in:Clinica chimica acta 2013-02, Vol.416, p.67-71
Main Authors: Pinheiro, M.B., Gomes, K.B., Dusse, L.M.S.
Format: Article
Language:English
Subjects:
Coagulation
Female
Fibrin - metabolism
Fibrinolysis
Humans
Kidney - pathology
Pre-Eclampsia - physiopathology
Preeclampsia
Pregnancy
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Summary:Preeclampsia (PE) is a multi-system disorder of human pregnancy characterized by hypertension and proteinuria. Although its pathogenesis is not fully understood, predisposition to endothelial dysfunction is thought to play a crucial part. Normotensive pregnancy is associated with increases in coagulation factor levels and decreases in natural anticoagulation, leading to a hypercoagulable state. This state is thought to be part of a complex physiological adaptation, which ensures rapid and effective control of bleeding from the placental site at the time of placental separation. In PE, a more pronounced exacerbation of the hypercoagulable state is noticed, compared to normotensive pregnancy. Activation of coagulation in PE occurs at an early stage of the disease and often antedates the clinical symptoms. It is known that PE is associated with fibrin deposition in the kidney glomerulus, and in fatal cases, widespread fibrin deposition has been a prominent histological finding. Related to the fibrinolytic system in PE, the state of the art allows the assumption that blood coagulation overlaps the fibrinolytic regulatory mechanism, since fibrin deposition in maternal microcirculation is usually found in PE. However, there is still no consensus about its specific role. This review aims to discuss the fibrinolytic system in PE and its potential implications to the pathogenesis of this disease. ► Fibrin deposition in maternal microcirculation is usually found in preeclampsia. ► There is still no consensus about the specific role of fibrinolytic system in PE. ► Blood coagulation seems to overlap the fibrinolytic regulatory mechanism in PE.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2012.10.060