Altered circulating thrombomodulin levels and antithrombin-III activity as evidence for varied activation of the coagulation cascade in severely versus mildly preeclamptic pregnancies

Objective: To determine the changes of circulating thrombomodulin levels and antithrombin-III activity in the activation of the coagulation cascade between severe and mild preeclampsia. Methods: Twenty women with mild preeclampsia and 10 with severe preeclampsia were matched with 30 normotensive healthy pregnant women. Maternal circulating thrombomodulin levels and antithrombin-III activities were measured by enzyme immunoassay and Microlatex particle-mediated immunoassay, respectively. Wilcoxon signed-rank test and conventional correlation coefficient were used for statistical analyses, Results: Circulating thrombomodulin levels were significantly higher in severe but not mild preeclamptics as compared with the matched controls, However, antithrombin-III activities were significantly lower in both severe and mild preeclampsia. Circulating thrombomodulin levels were inversely correlated with antithrombin activities in women with severe preeclampsia (r = -0.748, P = 0.01) but not in women with mild preeclampsia. Conclusions: Varied alterations of thrombomodulin levels and antithrombin-III activity between severe and mild preeclampsia may reflect a different degree of endothelial cell dysfunction in the activation of the coagulation cascade.