Des-gamma-carboxyprothrombin (PIVKA-II) levels in maternal serum throughout gestation.

The status of vitamin K in pregnant women was investigated using the highly sensitive method for des-gamma-carboxyprothrombin (protein induced by vitamin K absence [PIVKA-II]), electrochemiluminescence immunoassay. A gradual elevation of PIVKA-II related to gestational weeks was observed in healthy pregnant women, suggesting that a modest vitamin K deficiency takes place in gestation. Furthermore, throughout gestation the majority of pregnant women exceeded the healthy adult levels in PIVKA-II. Among complicated gestations of preeclampsia, a remarkable elevation of PIVKA-II was observed in severe preeclampsia, in which a high correlation between PIVKA-II level and coagulation parameters, including thrombin-antithrombin (TAT) complexes, was revealed. These data were suggestive that the vitamin K status readily decreased into a deficient status in hypercoagulative conditions. Among other complicated gestations, a moderate elevation of PIVKA-II was demonstrated in hyperemetic conditions, and, if at all, only a slight elevation of PIVKA-II was observed in other maternal diseases. The present study is the first report regarding the changes of PIVKA-II in pregnant women.