Features of hemostasis in pregnant women with preeclampsia and their association with endothelial injury marker: A retrospective analysis
DOI:
https://doi.org/10.37800/RM.2.2026.712Keywords:
preeclampsia, pregnancy, hemostasis, endothelial dysfunction, oxidative stress, microvesiclesAbstract
Relevance: Preeclampsia remains one of the leading causes of maternal and perinatal morbidity and mortality. It is characterized by arterial hypertension, proteinuria, and pronounced endothelial dysfunction. Hemostatic disturbances and endothelial injury are closely interrelated and determine the risk of thrombosis, placental insufficiency, and adverse pregnancy outcomes.
The study aimed to evaluate hemostatic parameters in third-trimester pregnant women with preeclampsia and their association with markers of endothelial damage.
Materials and Methods: A retrospective analysis was performed on 114 third-trimester pregnant women: 85 with moderate and severe preeclampsia and 29 conditionally healthy normotensive women. The following parameters were assessed: platelet count, mean platelet volume (MPV, fL), prothrombin index (PTI, %), activated partial thromboplastin time (aPTT, s), fibrinogen (g/L), membrane-bound hemoglobin (MBH, U/L), advanced oxidation protein products (AOPP, arbitrary units), oxidative stress markers in erythrocytes and plasma (OMB-ery and OMB-pl, nmol/mg protein), purine metabolism markers in erythrocytes and plasma (MG-ery and MG-pl, µmol/L), and erythrocyte-derived microvesicles (units/µL). Intergroup comparisons and Spearman correlation analysis were performed (p < 0.05).
Results: Patients with preeclampsia demonstrated thrombocytopenia, elevated MPV, PTI, and fibrinogen alongside shortened aPTT, consistent with a hypercoagulable state. Levels of AOPP, MBH, oxidative stress markers, and erythrocyte microvesicles were significantly elevated. Significant negative correlations were identified between coagulation parameters and markers of endothelial damage.
Conclusion: Preeclampsia in the third trimester is associated with activation of the platelet-coagulation system and endothelial injury. The negative correlations between PTI/fibrinogen and oxidative stress markers reflect a dynamic transition from hypercoagulation toward consumptive coagulopathy. Comprehensive assessment of hemostasis combined with endothelial dysfunction markers may improve risk stratification in pregnant women with preeclampsia.
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