Platelet Parameters in Nonthrombocytopenic Preeclampsia: A Case-Control Study

Ahmed J. Alhusaynei; Hanan Dh Nayyef

doi:10.32007/jfacmedbagdad.2084

Authors

Ahmed J. Alhusaynei Al-Khansaa Maternity Teaching Hospital, Directorate of Naniva Health, MOH, Iraq https://orcid.org/0000-0002-3635-9539
Hanan Dh Nayyef Al-Khansaa Maternity Teaching Hospital, Directorate of Naniva Health, MOH, Iraq https://orcid.org/0009-0005-7023-6195

DOI:

https://doi.org/10.32007/jfacmedbagdad.2084

Keywords:

Mean Platelet Volume, Platelet count, Platelet Distribution Width, Platelet parameters, Preeclampsia, Thrombocytopenia

Abstract

Background: Preeclampsia is a pregnancy-specific, multisystem condition characterized by the onset of de novo hypertension and proteinuria occurring in previously normotensive women after the twentieth week of pregnancy. Pregnancy is associated with a physiological adaptation that leads to changes in the hematological system including platelet parameters.

Objectives: Is to compare platelet count, and platelet indices, namely mean platelet volume platelet distribution width and platelet count to mean platelet volume MPV ratio in preeclamptic patients with normal pregnant women.

Patients & methods: A case-control study was carried out in the obstetrics and gynecology department at Al-Khansaa Maternity and Childhood Teaching Hospital, Mosul, Iraq over a period extending from February 2020 to the end of December 2020. A sample of 120 pregnant women participated in the study fulfilling inclusion criteria. Sixty of them were diagnosed with preeclampsia PE (30 pregnant women with mild PE and 30 pregnant women with severe PE) and sixty healthy pregnant women as the control group. Platelet count, mean platelet volume, and platelet distribution width (PDW) were measured and statistical analysis by mini tab program was done for all collected data.

Results: A significant linear correlation between mean platelet volume (MPV) and platelet distribution width (PDW) with mean arterial pressure in the Preeclampsia group with p-value of (0.025 and 0.001) respectively and a significant inverse correlation between the platelet count and mean arterial pressure with a p-value of (<0.001) was observed.

Conclusion: Platelet parameters are cost-effective, easily measurable, and practical markers that can be used for the monitoring of preeclampsia. Mean platelet volume (MPV) and platelet distribution width (PDW) have a significant linear correlation with mean arterial pressure in severe preeclampsia and can be used as a biomarker for the severity of preeclampsia in high-risk pregnant women.

Received: Mar, 2022

Accepted: July, 2023

Published: Jan.2024

Downloads

Download data is not yet available.

References

AL-Maini EH, Ali SI. The correlation between serum levels of soluble platelet-selectin in preeclampsia with & without intrauterine growth retardation versus normal pregnancy. J Fac Med Baghdad. 2017;59(1):36-41. https://doi.org/10.32007/jfacmedbagdad.591156.

American College of Obstetricians and Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' task force on hypertension in pregnancy. Obstetrics and gynecology, 2013; 122(5):1122-31. https://doi.org/10.1097/01.AOG.0000437382.03963.88.

Payne B, Magee LA, von Dadelszen P. Assessment, surveillance and prognosis in pre-eclampsia. Best practice & research Clinical obstetrics & gynaecology, 2011 Aug 1; 25(4):449-62. https://doi.org/10.1016/j.bpobgyn.2011.02.003.

Edmonds K. Hypertensive Disorders. In: Dewhurst's Textbook of Obstetrics & Gynaecology. Ninth edition. UK: John Wiley & Sons Ltd. 2018 Nov 12:73-84.

Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: A systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013 Sep 1; 170(1):1-7. https://doi.org/10.1016/j.ejogrb.2013.05.005.

Abass AE, Abdalla R, Omer I, Ahmed S, Khalid A, Elzein H. Evaluation of platelets count and indices in preeclampsia compared to normal pregnancies. IOSR Journal of Dental and Medical Sciences, 2016; 1(15):5-8. https://doi.org/10.9790/0853-150750508.

Kaur S, Khan S, Nigam A. Hematological profile and pregnancy: a review. International Journal of Advances in Medicine, 2014 Aug; 1(2):68-70. https://doi.org/10.5455/2349-3933.ijam20140804.

Mondal B, Paul DL, Sultana T, Rahman Q, Ahmed S, Fatema K et al. Assessment of platelet count and platelet indices in preeclampsia and eclampsia. The American Journal of Innovative Research and Applied Sciences, 2015; 1(3):80-4. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=b6072589dd01744f34b9b3a1815c606d010b25ad.

Asif N, Hassan K. Thrombocytopenia in pregnancy. Hematology & Transfusion International Journal, 2017; 5(5):1-4. https://doi.org/10.15406/htij.2017.05.00133.

Bain BJ, Bates I, Laffan MA. Investigation of haemostasis. In: Dacie and Lewis 46 Practical Haematology. Twelfth edition. London: E-Book: Expert Consult: Online and Print. Elsevier Health Sciences. 2016: 336-409.

Jarjees SB. Evaluation of platelet count and mean platelet volume in normal and preeclamptic pregnant women. Dissertation : Arab Board for Medical Specialization in Obstetrics and Gynaecology.2011.

Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical, and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28. https://doi.org/10.5603/GP.a2021.0056.

Doğru HY, Yücel N, Pelit FÇ, Bolat G. The importance and evaluation of mean platelet volume on the severity of preeclampsia. Perinatal Journal, 2011; 19(3):108-113. https://doi.org/10.2399/prn.11.0193002.

Tzur T, Sheiner E. Is there an association between platelet count during the first trimester and preeclampsia or other obstetric complications later in pregnancy? . Hypertension in pregnancy, 2013; 32(1):74-82. https://doi.org/10.3109/10641955.2012.704109.

Wang F, Meng Z, Li S, Zhang Y, Wu H. Platelet distribution width levels can be a predictor in the diagnosis of persistent organ failure in acute pancreatitis. Gastroenterology research and practice. 2017. https://doi.org/10.1155/2017/8374215.

Boshnak N, Boshnaq M, Elgohary H. Evaluation of platelet indices and red cell distribution width as new biomarkers for the diagnosis of acute appendicitis. Journal of Investigative Surgery. 2018;31(2):121-9. https://doi.org/10.1080/08941939.2017.1284964.

Tzur I, Barchel D, Izhakian S, Swarka M, Garach-Jehoshua O, Krutkina E, Plotnikov G, Gorelik O. Platelet distribution width: a novel prognostic marker in an internal medicine ward. Journal of Community Hospital Internal Medicine Perspectives. 2019;9(6):464-70.

https://doi.org/10.1080/20009666.2019.1688095.

Varol E, Akcay S, Icli A, Yucel H, Ozkan E, Erdogan D et al. Mean platelet volume in patients with prehypertension and hypertension. Clinical hemorheology and microcirculation. 2010; 45(1):67-72. https://doi.org/10.3233/CH-2010-1327.

Thanoon AM, Jalal SD. Thrombocytopenia in Iraqi Pregnant Women. JFac Med Baghdad. 2011; 53(2):171-4. https://doi.org/10.32007/jfacmedbagdad.532864.

NICE guideline criteria for preeclampsia diagnosis/2020. https://action-on-pre-eclampsia.org.uk/wp-content/uploads/2020/01/NICE_guidance_on-Pre-eclampsia_VB2020.pdf.

Stekkinger E, Zandstra M, Peeters LL, Spaanderman ME. Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome. Obstetrics & Gynecology, 2009 Nov 1; 114(5):1076-84. https://doi.org/10.1097/AOG.0b013e3181b7b242.

Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ER et al. preeclampsia and hypertensive disorder. In: Obstetrics: Normal and Problem Pregnancies. Seventh edition. London: E-book. Elsevier Health Sciences. 2016; 661-705.

A. Jagroop, I. Clatworthy, J. Lewin, DP Mikhailidis I. Shape change in human platelets: measurement with a channelyzer and visualisation by electron microscopy. Platelets, 2000; 11(1):28-32. https://doi.org/10.1080/09537100075760.

Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M. Can platelet count and platelet indices predict the risk and the prognosis of preeclampsia?. Hypertension in pregnancy, 2015; 34(4):434-42. https://doi.org/10.3109/10641955.2015.1060244.

AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vascular health and risk management, 2016; 12:477. https://doi.org/10.2147/VHRM.S120944.

Vijaya C, Lekha MB, Shetty A, Geethamani V. Evaluation of platelet counts and platelet indices and their significant role in preeclampsia and eclampsia. Journal of Evolution of Medical and Dental Sciences, 2014; 3(12):3216-20.

https://doi.org/10.14260/jemds/2014/2269.

Annam V, Srinivasa K, Yatnatti SK. Evaluation of platelet indices and platelet counts and their significance in pre-eclampsia and eclampsia. Int J Biol Med Res. 2011;2(1):425-8.

https://www.researchgate.net/profile/VamseedharAnnam/publication/48347108_Evaluation_of_platelet_indices_and_platelet_counts_and_their_significance_in_pre-eclampsia_and_eclampsia/links/0deec5245ae19abefa000000/Evaluation-of-platelet-indices-and-platelet-counts-and-their-significance-in-pre-eclampsia-and-eclampsia.pdf.

Dhakre R, Nandmer GK, Sapkal R. Correlation of platelet indices with severity of preeclampsia: a prospective study from central India. International Journal Reprod Contracept Obstet Gynecol, 2018; 7(4):1416-20. https://doi.org/10.18203/2320-1770.ijrcog20181327.

Nooh AM, Abdeldayem HM. Changes in platelet indices during pregnancy as potential markers for prediction of preeclampsia development. Open Journal of Obstetrics and Gynecology, 2015; 5(12):703. https://doi.org/10.4236/ojog.2015.512099.

Dundar O, Yoruk P, Tutuncu L, Akyol Erikci A, Muhcu M, Ergur AR et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of preeclampsia. Prenatal Diagnosis: Affiliation With the International Society for Prenatal Diagnosis, 2008; 28(11):1052-6. https://doi.org/10.1002/pd.2126.

. Reddy SG, Prasad CS. Significance of platelet indices as severity marker in nonthrombocytopenic preeclampsia cases. Journal of laboratory physicians, 2019 Jul; 11(3):186. https://doi.org/10.4103/JLP.JLP_161_18.

Ünlü BS, Acay A, Köken GG, Yildiz Y, Telciler E, Pektaş MK, Ariöz DT, Yilmazer M. The Role of Mean Platelet Volume in Preeclampsia. Journal of Turgut Ozal Medical Center. 2014;21(3). https://doi.org/10.7247/jtomc.2014.1638

Ceyhan T, Beyan C, Başer İ, Kaptan K, Güngör S, Ifran A. The effect of preeclampsia on complete blood count, platelet count and mean platelet volume. Annals of hematology, 2006; 85(5):320-2. https://doi.org/10.1007/s00277-006-0091-7.

Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014; 175:107-11.

https://doi.org/10.1016/j.ejogrb.2013.12.036