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Serum and Urine Fibrinogen Derivatives in Normal Pregnancy and Preeclampsia

From the Department of Medicine. The Royal Postgraduate Medical School and the Institute of Obstetrics and Gynaecology. Hammersmith Hospital, London W12 OHS.

Serial measurements of scrum and urine fibrinogen derivatives (FD) were made in 28 initially normal primigravidas. Eight additional patients with established prccrlampsia were also studied, and serial measurements were undertaken in 2 further patients with severe preeclampsia. No rise in either serum or urine FD tiler occurred during the first two trimesters of pregnancy. Sporadic inconsistent increases in serum or urine FD tiler occurred during the third trimester of some normal pregnancies. In 6 patients in the prospective study who developed precclampsia, no rise in serum or urine FD titer occurred before the diagnosis was made clinically; thus the lest did not predict the development of preeclampsia. An elevation of scrum or urine FD liter was not detected consistently in prceclampsia, but serial measurements of serum and urine FD in severe precclampsia indicated the test might serve as a useful monitor for the reversal of hypertensive vascular damage. These observations do not support the hypothesis that disseminated intravascular coagulation constitutes an important primary pathogenctic mechanism in preeclampsia.