Platelet Indices in Preeclampsia and Normotensive Pregnancy in a Tertiary Care Centre: A Cross-sectional Study

Abstract

Introduction: Preeclampsia is a serious pregnancy-related complication. Platelets are potentially important in the pathogenesis of preeclampsia, and platelet function analyses may prove as a sensitive preeclampsia biomarkers. It is well established that pregnancy itself induces a pro-coagulant state due to a rise in the levels of pro-coagulant proteins and a lower level of some endogenous natural anticoagulants. Additionally, it has been reported that preeclampsia is associated with an increase in platelet function. Aim: To assess the platelet indices in preeclamptic and normotensive pregnant women. Materials and Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India. A total of 132 pregnant women were involved in this study. Among them 66 were preeclamptic women treated as cases (Group A) and 66 were normotensive pregnant treated as controls (Group B). The duration of the study was from October 2018 to July 2020. A detailed clinical history along with the antenatal examination was done. The Blood Pressure (BP) recording were documented and for the patient with hypertension repeat BP recording after four hours were documented. Complete blood count was done for all the patients and White Blood Cells (WBC), Platelet Count (PC), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) were documented in all the patients. Comparison was done between the platelet indices of normotensive pregnant women and women with preeclampsia using Chi-square test. Results: In this study, majority of the subjects were in the age group of 21-30 years in group A and 18-25 years in group B. The PC was 50,000-1 lac in about 26 (39.4%) in group A. The mean PDW (fl) was 12.62±2.14 in group A and in group B it was 10.98±1.06. The mean MPV (fl) (femtoliter) was 10.27±1.11 in group A and in group B 9.81±1.01. There was a statistically significant difference in clinical parameters like PC, PDW (fl) and MPV (fl) between the study groups (p-value <0.05). In the present study, adverse foetal outcomes were more in group A than group B. In group A, 40 babies born to preeclamptic mothers showed adverse outcomes. Twelve (30%) cases suffered Intrauterine Growth Restriction (IUGR). In group A, 39 cases and in group B 26 cases showed maternal abnormalities. Placental abruption was observed in 9 (23.08%) patients of group A and 2 (7.69%) in group B and anaemia was observed in 9 (23.08%) patients in group A and 7 (26.92%) in group B. Conclusion: This study concluded that there is decrease in PC and increase in the platelet indices like MPV, PDW, in preeclampsia women as compared to normal pregnant women. Adverse neonatal outcomes like IUGR and foetal distress were also found to be more in women with preeclampsia (not statistically significant). Particularly in developing countries like India, the platelet indices can be used as effective biomarkers which are both easy and economical to obtain. Platelet indices can be used as a prognostic tool, for prediction of preeclampsia and help in improving the feto-maternal outcome.

Keywords

• mean platelet volume
• platelet count
• platelet distribution width