Thromb Haemost 1991; 65(05): 474-477
DOI: 10.1055/s-0038-1648174
Original Article
Schattauer GmbH Stuttgart

Detection of Platelet Desensitization in Pregnancy-Induced Hypertension Is Dependent on the Agonist Used

Y Ahmed
The Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom
,
M H F Sullivan
The Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom
,
M G Elder
The Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Received 25 September 1990

Accepted after revision 14 December 1990

Publication Date:
24 July 2018 (online)

Summary

The aggregation of platelets from women with pregnancy-induced hypertension (P.I.H.), or with normal pregnancies, in response to arachidonic acid, ADP, collagen or platelet activating factor (PAF) was examined. No differences in platelet aggregation between the normotensive and hypertensive women were detected when arachidonic acid or collagen were used to stimulate in vitro platelet aggregation. Higher concentrations of ADP and PAF were required to aggregate platelets from women with P.I.H. compared with platelets from normotensive controls. Platelets from women with normotensive pregnancies (n = 80) aggregated maximally in response to 20 nM PAF without exception. Reversible aggregation by platelets from women with P.I.H. (n = 25) was observed at the same concentration of PAF; again, this was found in all subjects tested. These results indicate that PAF at a concentration of 20 nM can clearly demonstrate differences in aggregation of platelets from women with normotensive pregnancy and women with P.I.H.

 
  • References

  • 1 Howie PW, Prentice CRM, McNicol GP. Coagulation, fibrinolysis and platelet function in pre-eclampsia, essential hypertension and placental insufficiency. J Obstet Gynaecol Br Commonw 1971; 78: 992-1003
  • 2 Trudinger BJ. Platelets and intra-uterine growth retardation in preeclampsia. Br J Obstet Gynaecol 1976; 83: 284-286
  • 3 Whigham KAE, Howie PW, Drummond AH, Prentice CRM. Abnormal platelet function in pre-eclampsia. Br J Obstet Gynaecol 1978; 85: 28-32
  • 4 Morrison R, Crawford J, Macpherson M, Hepstinstall S. Platelet behaviour in normal pregnancy, pregnancy complicated by essential hypertension and pregnancy-induced hypertension. Thromb Haemo-stas 1985; 54: 607-611
  • 5 Beaufils M, Uzan S, Donsimoni R, Colau JC. Prevention of preeclampsia by early anti-platelet therapy. Lancet 1985; i: 840-843
  • 6 Wallenburg HCS, Dekker GA, Makovitz JW, Rotmans P. Low-dose aspirin prevents pregnancy-induced hypertension and pre-eclampsia in angiotensin-sensitive primigravidae. Lancet 1986; i: 1-3
  • 7 Elder MG, de Swiet M, Robertson A, Elder MA, Flloyd E, Hawkins DF. Low-dose aspirin in pregnancy. Lancet 1988; i: 410-412
  • 8 Inglis TCM, Stuart J, George AJ, Davies AJ. Haemostatic and rheological changes in normal pregnancy and pre-eclampsia. Br J Haematol 1982; 50: 461-465
  • 9 O’Brien WF, Saba HJ, Knüppel RA, Scerbo JC, Cohen JR. Alterations in platelet concentration and aggregation in normal pregnancy and pre-eclampsia. Am J Obstet Gynecol 1986; 155: 486-490
  • 10 Hanahan DJ. Platelet activating factor: A biologically active phos-phoglyceride. Annu Rev Biochem 1986; 55: 483-509
  • 11 Chesney CM. Agonists and receptors: platelet activating factor (PAF-acether). In: Platelet Responses and Metabolism Holmsen H. (ed) 1987. II: Elsevier; (Amsterdam, London, New York): pp 83-92
  • 12 Chignard M, Keraly CL, Nunez D, Coeffier E, Benveniste J. PAF-acether and platelets. In: Platelets in Biology and Pathology MacIntyre DE, Gordon JL. (eds) 1987. III: Publ CRC Press; (London and New York): pp 289-315
  • 13 Sullivan MHF, Zosmer A, Gleeson RP, Elder MG. Equivalent inhibition of in vivo platelet function by low dose and high dose aspirin treatment. Prost Leuk Essent Fatty Acids 1990; 39: 319-321
  • 14 Stirling Y, Woolf L, North WRS, Seghatchian MJ, Meade TW. Haemostasis in normal pregnancy. Thromb Haemostas 1984; 52: 176-184
  • 15 Greer IA, Calder AA, Walker JJ, Lunan CB, Tulloch I. Increased platelet reactivity in pregnancy-induced hypertension and uncomplicated diabetic pregnancy; an indication for anti-platelet therapy?. Br J Obstet Gynaecol 1988; 95: 1204-1208
  • 16 de Boer K, ten Cate JW, Sturk A, Borm JJJ, Treffers PE. pEnhanced thrombin generation in normal and hypertensive pregnancy. Am J Obstet Gynecol 1989; 160: 95-100
  • 17 Wallenburg HCS, Van Kessel L. Platelet lifespan in normal pregnancy as determined by a non-radioisotopic technique. Br J Obstet Gynaecol 1978; 85: 33-36
  • 18 Friedman SA. Pre-eclampsia: A review of the role of prostaglandins. Obstet Gynecol 1988; 71: 122-137
  • 19 Redman CWG, Bonnar J, Beilin L. Early platelet consumption in preeclampsia. Br Med J 1978; 1: 467-469
  • 20 Ballegeer V, Spitz BV, Kieckens L, Moreau H, Van Assche A, Collen D. Predictive value of increased plasma levels of fibronectin in gestational hypertension. Am J Obstet Gynecol 1989; 161: 432-436
  • 21 Sullivan MHF, Johnson S, Elder MG. Platelet malfunction preceding the onset of pregnancy induced hypertension. J Obstet Gynaecol 1990; 10: 215-216
  • 22 Gant NF, Daley GL, Chard S, Whalley PJ, MacDonald PC. A study of angiotension II pressor response throughout primigravid pregnancy. J Clin Invest 1973; 52: 2682-2689
  • 23 Lao TT, Chin RRH. Blood pressure during first and second trimesters as predictors of pre-eclampsia. Am J Obstet Gynecol 1988; 159: 1017-1018
  • 24 Marya EK, Rathee S, Mittal R. Evaluation of three clinical tests for predicting pregnancy-induced hypertension. Am J Obstet Gynecol 1988; 158: 683-684
  • 25 Sibai BM. Pitfalls in the diagnosis and management of pre-eclampsia. Am J Obstet Gynecol 1988; 159: 1-5
  • 26 Kelton JG, Julian J, Boland V, Carter CJ, Gent M, Hirsh J. Sex-related differences in platelet aggregation: influence of the haemato-crit. Blood 1980; 56: 38-41
  • 27 Heilmann L. Blood rheology and pregnancy. Balliere’s Clin Haematol 1987; 1: 777-799