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Human Reproduction, Vol. 10, No. suppl_2, pp. 121-131, 1995
© 1995 European Society of Human Reproduction and Embryology

Fibrinolytic system and reproductive process with special reference to fibrinolytic failure in pre-eclampsia

J. Gilabert1, A. Estellés2, S. Grancha2, F. España2 and J. Aznar3

Maternal Center, ‘La Fe’ University Hospital Valencia, Spain 2 Research Center ‘La Fe’ University Hospital Valencia, Spain 3 Department of Clinical Pathology, ‘La Fe’ University Hospital Valencia, Spain

Correspondence: 1Hospital Maternal y Centro de Investigación, Hospital La Fe, Avda de Campanar 21, 46009 Valencia, Spain

Here we summarize the recent progress in research on the role of the fibrinolytic system in reproduction, with a special emphasis on the role of the plasminogen activator inhibitors in fetal development. Trophoblasts produce fibrinolytic proteins that can promote normal implantation and regulate blood flow to the fetus and placenta throughout pregnancy. Normal pregnancy is associated with a hypofibrinolytic state that is fundamentally caused by an increase in plasminogen activator inhibitors types 1 and 2. In pre-eclampsia, a fibrinolytic failure, resulting from an increase in plasma and placental concentrations of plasminogen activator inhibitor-1, was observed. The localized elevated concentrations of placenta plasminogen activator inhibitor-1 protein and mRNA observed in pre-eclamptic patients would be expected to foster the deposition of fibrin and thus play a role in the complications associated with this disease. The decreased plasminogen activator inhibitor-2 concentrations in placenta and plasma from intrauterine fetal growth retardation pregnancies and the positive correlation between plasma/placenta plasminogen activator inhibitor-2 concentration and birthweight suggest that this inhibitor could be considered an adequate marker of placental function.

Key words: fibrinolysis/placenta/plasminogen activator inhibitors/pre-eclampsia/pregnancy/reproduction


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