Altered circulating thrombomodulin and fibronectin levels as evidence for different degrees of vascular endothelial damage between severe and mild preeclampsia

Objective: The purpose of this study is to determine the severity of disease in preeclamptic pregnancies with two circulating endothelial factors, thrombomodulin and fibronectin. Methods: Sixty women with singleton pregnancies in the third trimester were studied. Twenty with mild preeclampsia and 10 with severe preeclampsia were matched with 30 normotensive pregnant women. Maternal serum thrombomodulin and fibronectin levels were measured by enzyme immunoassay and microlatex particle-mediated immunoassay. Results: Serum fibronectin levels were significantly higher in both severely and mildly preeclamptic women than the matched controls (P < 0.0005). However, serum thrombomodulin levels were only elevated in severely (P < 0.005), but not in mildly preeclamptic groups. Moreover, there was no significant correlation between serum thrombomodulin and fibronectin levels in preeclamptic pregnancies (r = 0.3686, P > 0.05). Conclusions: Elevated serum thrombomodulin and fibronectin levels in pregnant women with preeclampsia provide evidence for the endothelial cell dysfunction in the pathological changes occurring in preeclamptic pregnancies. Circulating thrombomodulin levels may serve as a better marker in differentiating the severity of disease in preeclamptic pregnancies.