Changes of plasma and placental tissue factor pathway inhibitor-2 in women with preeclampsia and normal pregnancy

Objectives

To investigate the maternal and fetal plasma changes of tissue factor pathway inibitor-2 (TFPI-2) and its placental expression in women with normal pregnancy and preeclampsia.

Material and methods

We assessed the plasma TFPI-2 level in non-pregnant, normal pregnant and postpartum women, detected fetal plasma level and expression in placenta, and compared the changes in women with preeclampsia. Time-resolved fluoroimmunoassay and immunohistochemistry were used for plasma and placenta tissue detection, respectively.

Results

Maternal plasma levels of TFPI-2 in normal pregnant women at 13 weeks of gestation increased 9.3 times as compared with healthy non-pregnant women (149.3 ± 17.1 versus 16.0 ± 3.6 ng/ml),reached a maximum level ( 282.6 ± 17.1 ng/ml) at 39 weeks of gestation, and dramatically decreased to nearly a non-pregnant level on the first day of postpartum (32.3 ± 7.1 ng/ml); similar change was found in the placental expression. Fetal plasma TFPI-2 was significantly lower than the maternal level at delivery. The maternal plasma TFPI-2 in preeclampsia was significantly lower compared with that in normal pregnancy, coupled with significantly higher placental expression.

Conclusions

Placenta may be the main site of the high level of TFPI-2 production in maternal circulation, and the dramatic changes in preeclampsia provide a clue to elucidate its pathogenesis.