Impaired Fibrinolysis in Pregnancy Failure

Objective: To explore the association between plasma plasminogen activator inhibitor 1 (PAI-1) levels and women experiencing recurrent miscarriages with no live births to those who have had one or more live births. Methodology: This cross-sectional study included healthy women aged 18–35 years with a history of two or more consecutive miscarriages before 20 weeks of gestation, after obtaining ethical approval and informed consent. The study was conducted in a local private hospital in Karachi, Pakistan. Women with medical and reproductive disorders were excluded. Seventy-five females were selected for the collection of blood samples. Plasma Plasminogen Activator Inhibitor-1 (PAI-1) levels were measured using a Human PAI-1 ELISA kit. Results: Among women with recurrent pregnancy loss, 18.7% had elevated PAI-1 levels, which was significantly correlated with fewer live births (P < 0.05). Notably, 87.5% of those with increased PAI-1 had no live children, while only 12.5% had two or more live children. Conclusion: Elevated plasma levels of Plasminogen Activator Inhibitor-1 can disrupt fetomaternal circulation and may contribute to recurrent pregnancy loss.