PAI-1 and tPA as markers of severity among pre-eclamptics in a tertiary institution in north central Nigeria


Objectives: Endothelial dysfunction contributes to the pathogenesis of pre-eclampsia as well as increased production of some factors such as tissue plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1). These factors are said to be biomarkers of pre-eclampsia but their role in assessing the severity of pre-eclampsia is underreported. Methodology: A cross-sectional study involving 85 subjects with pre-eclampsia. They were classified clinically as having mild or severe pre-eclampsia using ACOG classification. Blood and urine samples were collected for determining tPA, PAI-1, D-dimer and proteinuria in the two groups. Clinical and laboratory values were compared using the IBM®SPSS 20.0 (2011) soft ware packages. Results: The mean age of the respondents was 29.9±5.2 years. Forty-five (52.9%) of the subjects had severe pre-eclampsia while 40(47.1%) had mild pre-eclampsia. The median values of tPA and PAI-1 of subjects with severe pre-eclampsia were significantly higher than the corresponding values in subjects with mild pre-eclampsia (each p=0.001). There was a positive correlation between each of the tPA and PAI-1 levels with the degree of severity of pre-eclampsia (p=0.001 each). Conclusion: Fibrinolytic proteins like tPA and PAI- 1 are useful in assessing the severity of preeclampsia.