Pregnant women with pre-eclampsia have a significant increase in the degree of platelet aggregation in response to ADP, in comparison with a physiologically occurring pregnancy, allowing use this criterion for diagnostic purposes. In vitro experiments revealed that diadenosine-5’,5’’’-P1,P4-tetraphosphate (Ap4A) and ATP-Mg2+ exhibited the greatest inhibitory effect on ADPinduced platelet aggregation. At the same time, a decrease in the degree of platelet aggregation in pre-eclampsia reached the level noted during physiological pregnancy. The potential advantage of Ap4A and its derivatives as therapeutic antiplatelet agents is that they have a synergistic inhibitory effect on the P2Y1 and P2Y12 platelet receptors and have a longer half-life in the bloodstream compared to ATP. The research results suggest using Ap4A as a substrate for the development of drugs aimed at reducing the increased functional activity of platelets in pre-eclampsia.

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