The Correlation Research About The ADAMTS13 Activity In Maternal Blood And Cord Blood Of Pregnant Women During Severe Preeclampsia And Human Cytomegalovirus Infection

[Objective] To investigate the molecular mechanism of placenta thrombosis with intrauterine infection and comprehend the influence on activity of von Willebrand factor cleaving protease (ADAMTS13) of maternal blood and cord blood by human cytomegalovirus (HCMV) during the late pregnancy.[Methods] First, we tested HCMV DAN of cord blood by using polymerase chain reaction(PCR), if positive,then HCMV mRNA was tested by using reverse transcriptase-polymerase chain reaction (RT-PCR). Both HCMV DNA and mRNA being positive in cord blood were judged as intrauterine active infection. The intrauterine infection group included 28 cases of both HCMV DNA and mRNA being positive in cord blood; The control group was composed of 69 cases of both cord blood and placenta HCMV DNA being negative. The cases including any of case abnormal history of pregnancy and childbirth or pathological pregnancy or pregnancy complications were rejected. We detected the activity of ADAMTS13 in maternal blood and cord blood by using Residual-collagen Binding Assay.[Results] 1. Group:The control group was composed of 68 cases and the intrauterine infection group included 28 cases from the late pregnancy. The cord blood intrauterine infection group was divided into inactive infection 16 cases and active infection 12 cases.2. The results of activity of ADAMTS13 in maternal blood The activity of ADAMTS13 in control group and intrauterine infection group were (1.13±0.86)% and (2.24±1.85) % respectively, precise dipl-possibility P=0.010< 0.05,95% confidence interval (-1.93,-0.29), so the activity of ADAMTS13 in maternal blood of the intrauterine infection group was higher.3. The results of activity of ADAMTS13 in cord blood①The activity of ADAMTS13 in control group and intrauterine infection group were (0.40±0.31)% and (1.11±0.88) % respectively, precise dipl-possibility P=0.000< 0.05,95% confidence interval (-1.06,-0.36), so the activity of ADAMTS 13 in cord blood of the intrauterine infection group was higher.②Among the intrauterine infection group, the activity of ADAMTS 13 in the cases of HCMV mRNA positive and negative were (0.97±0.83)% and (1.21±0.93)% respectively, precise dipl-possibility P=0.488> 0.05,95% confidence interval (-0.46, 0.94), so the activity of ADAMTS 13 in intrauterine inactive infection group was higher but no statistically significant difference.③Compared the cases of HCMV DNA positive、mRNA negative with the control group, we arrived at the precise dipl-possibility P=0.003 <0.05,95% confidence interval (-1.31,-0.31), so the activity of ADAMTS13 in intrauterine inactive infection group was higher. Compared the cases of HCMV DNA、mRNA positive with the control group, we arrived at the precise dipl-possibility P=0.037< 0.05,95% confidence interval (-1.11,-0.04), so the activity of ADAMTS 13 in intrauterine active infection group was higher.[Conclusion] Activity of ADAMTS 13 of the late pregnancy in maternal blood and cord blood was increased by HCMV intrauterine infection, which maybe one of the important molecular mechanism that placental vascular microthrombus had formed owing to HCMV infected and then led to embryonic dysplasia even death. [Objective] Joint analysis of ADAMTS13 activity、vWF antigen、the multiners of vWF in maternal blood and vWF antigen in cord blood durning severe preeclampsia. Explore the correlation between ADAMTS13 activity、vWF antigen、the multiners of vWF and severe preeclampsia even other pregnancy-related thrombotic disease.[Methods] Here, we selected 30 health pregnant women and 25 pregnant women with severe preeclampsia,30 health women of childbearing age,22 women with family planning voluntary abortion at mid-pregnancy. The cases including any of case abnormal history of pregnancy and childbirth or other pathological obstetrics factors were rejected. Diagnostic criteria of severe preeclampsia from《williams Obstetrics》(22 edition).The detection methods as following:the cleavage activity of ADAMTS13 were detected by a newly-developed fluorescence resonance energy transfer (FRET), the level of vWF antigen were analyzed by double-antibody sandwich enzyme-linked immunosorbent assay and the multiners of vWF were analyzed by sodium dodecyl sulfate-argarose gel elect-rophoresis (SDS-AGE).[Results] 1. Coefficient of variation for FRET assay inner-batch and inter-batch were 3.69% and 6.91% respectively. The serum and plasma ADAMTS13 activity in 30 health women of childbearing age were (85.7±4.6)% and (89.2±5.8)% respectively (P>0.05). The activity of AD AMTS 13 in 22 health mid-pregnancy women and 30 health late pregnant women were (98.9±18.7)% and (84.1±19.4)% respectively (P<0.05) Compared the cases of 25 severe preeclampsia in pregnant women (95.6±15.0) with 30 health late pregnant women, we arrived at the precise dipl-possibility P>0.05.2. Coefficient of variation for double-antibody sandwich enzyme-linked immunosorbent assay inner-batch and inter-batch were 4.23% and 7.19% respectively. The serum and plasma vWF antigen in 30 health women of childbearing age were (107.3±4.3)% and (108.9±4.5) % respectively (P>0.05).The antigen of vWF in 22 health mid-pregnancy women and 30 health late pregnant women were (88.8±22.6)% and (103.7±22.6)% respectively (P >0.05). Compared the cases of 25 severe preeclampsia in pregnant women with 30 health late pregnant women, vWF antigen of maternal blood in former was (116.1±19.1),we arrived at the precise dipl-possibility P<0.01; Compared the cases of 25 severe preeclampsia in pregnant women with 30 health late pregnant women, vWF antigen of cord blood were (77.3±18.2)% and (93.9±26.8)% respectively, we arrived at the precise dipl-possibility P<0.05.3. The multimers of vWF in 30 health late pregnancy women and 25 severe preeclampsia in pregnant women were (112.6±151.9)% and (871.0±874.4) % respectively (P＜0.01)[Conclusion] In late pregnancy, the antigen of vWF increased and the activity of ADAMTS13 decreased, there are conducive to the prevention of postpartum hemorrhage. Increased the antigen and multimers of vWF but no change in activity of ADAMTS13 durning severe preeclampsia can be due to endothelial injury. That would lead to microthrombosis state.