The predictive value of plasma fibronectin and antithrombin III levels in early prediction of pre-eclampsia

Abstract

OBJECTIVE :Current concepts of pathogenesis of pre-eclampsia involve the generalized disfunction of maternal vascular endothelial cell. We measured the endotelial damage isoform of Fibronectin as a marker of endothelial cell injury and antithrombin III as a marker of intravascular coagulation, throughout pregnancy in a prospective, case- control study. STUDY DESIGN: We carried out a prospective study of eighty primigravida. Seventy- four of them were succesfully followed-up delivery and pre-eclampsia developed in 14 subjects (18.9%) of this group. Evaluation of predictive tests, as well as t and chi- squared statistical test, were used for analysis of date. RESULT: Pre-eclamptic and normotensive groups .showed significant differences in terms of fibronectin levels (p<0. 001).But there was no significant difference in terms of plasma antithrombin III levels in 24-38 gestationel age (p>0.05). The sensitivity .specificity, positive predictive values (PPV), negative predictive values (NPV) for plasma fibronectin levels measured during the period of twenty-four and thirty- eight weeks were 85%, 92%, 92%, and 96 %, respectively. In healtly primagravida the fibronectin and antithrombin III levels 318.30+52.31 mg/ml 306.08+22.81 mg/ml respectively. In Pre-eclamptic were 507.14+71.15 mg/ml, 305.42+22.37 mg/ml respectively. CONCLUSIONS : We conclude that to diagnose pre-eclampsia before the onset of clinical symptoms. We found that plasma fibronectin levels increased 4 weeks before the onset of clinical symptoms.