The role of antithrombin III in critical patients in obstetrics.

A preliminary study was conducted to detect significant differences between the inflammatory cytokines network recorded in mild and severe preeclampsia compared with normal pregnancy. 36 patients were divided in two groups: (NP) normal pregnancy and (SPH) Severe Preeclampsia and HELLP syndrome. Inflammatory cytokines (IL 6, TNF, IL 10), Antithrombin III (AT III), Protein C (PC) and Tissue Factor Pathway Inhibitor (TFPI) plasma level and Organ Disfunction modified Score (ODS) were recorded. Results shows a difference (P<0,05 ) for AT III and other markers levels in the two groups and, inside of the SPH group, between Severe preeclampsia patients and HELLP syndrome patients. A correlation was found between coagulation natural inhibitors, specially antithrombin III, and the clinical scores. Performing a Caesarean section did not change these results. Based on results of the study we have designed a monitoring and a treatment protocol in our obstetric and general ICU. A multicentric study is now ongoing to validate the preliminary data on the substitutive treatment with AT III.