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Thrombin activatable fibrinolysis inhibitor antigen and activity levels in normal pregnancy
  1. FY Huq1,
  2. C Chi1,
  3. A Riddell1,
  4. B Whitlow2,
  5. RA Kadir1,3
  1. 1Haemophilia Centre and Haemostasis Unit, Royal Free Hospital, London, UK
  2. 2Department of Obstetrics and Gynaecology, Colchester General Hospital, Essex, UK
  3. 3Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK

Abstract

Background Thrombin activatable fibrinolysis (TAFI) is a glycoprotein that inhibits fibrinolysis. Pro-TAFI is cleaved by Factor IIa – Thrombomodulin complex, producing actived TAFI (TAFI:Ac).

Pregnancy is a hypercoaguable state associated with increased levels of pro-coagulant factors; enhanced thrombin generation and impaired fibrinolysis.

TAFI may contribute to the decreased fibrinolysis seen in pregnancy.

Currently there are conflicting reports on TAFI antigen (TAFI:Ag) levels in pregnancy and no data on the dynamic changes in levels and activity during pregnancy and its correlation with adverse pregnancy outcome.

Method Consecutive TAFI:Ag and activity (TAFI:Ac) levels were measured during the first, second and third trimester in 80 women.

All participants in the study had no co-morbidities and had an uncomplicated singleton pregnancy.

Results TAFI:Ag levels significantly increased with gestation peaking in the third trimester with mean levels of 120, 139 and 148 μg/ml in the first, second and third trimesters respectively (p<0.035).

TAFI:Ac levels significantly increased between the first and second trimesters with mean values of 47 and 52 μg/ml respectively (p<0.01). TAFI:Ac levels then plateaued in the third trimester (with a mean value of 53 μg/ml).

Conclusion TAFI antigen and activity levels are increased in normal pregnancy

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