Study of prognostic significance of platelet count as a predictor of severity of preeclampsia
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251983Keywords:
Pre-eclampsia, Platelet count, Gravida, Antepartum haemorrhage, Cesarian sectionAbstract
Background: Pre-eclampsia is a pregnancy-specific syndrome, recognised from antiquity as a leading cause of maternal and perinatal mortality, and it accounts for almost 15% of pregnancy associated death. Hence, the current study was planned to assess the role of platelet count as a predictor of the severity of preeclampsia and its prognosis.
Methods: In this retrospective analytical study, a total of 100 pregnant women with preeclampsia were included and divided into two groups of non-severe and severe. Demographic data, socio-economic status, period of gestation and platelet count were recorded and compared.
Results: The average age of patients was 27.07±5.14 years, with no significant difference between patients based on preeclampsia severity. Most of the patients were multigravida females (69%). The distribution based on the socio-economic status was similar, with no significant difference (p>0.05). The average period of gestation was 36.01±3.41 weeks in the study. The average platelet count of patients with severe preeclampsia at the time of admission was seen to be lower compared to the non-severe patients. A ROC curve analysis was done to assess the ability of platelet count to differentiate severe PWE from non-severe PE. The area under the curve was high at 0.879. The LSCS rate was 54% in the study, followed by Pre-term birth seen in 48% of patients. There was no significant difference between the two groups in terms of maternal outcome parameter-based distribution. The proportion of patients with APGAR score <7 at 5 minutes was significantly higher in the non-severe PE group. It was seen that preeclamptic patients were associated with a significantly higher prevalence of pre-term birth and Ante partum haemorrhage (APH).
Conclusions: Platelet count is an accurate predictor of severe preeclampsia in pregnant females. The patients with low platelet counts were associated with significantly higher adverse pregnancy outcomes, as suggested by a significantly higher prevalence of pre-term birth, APH and rate of LSCS.
Metrics
References
Bilhartz TD and Bilhartz PA. Navigating the perfect storm: Confronting the epidemic of hypertensive disorders in pregnancy. Eä Rev Human Med Estud Soc Ciencia Tecnol. 2010;2:1852-4680.
Hiralal K. Hypertensive disorders in pregnancy.In: DC Dutta‟s textbook of Obstetrics 9th ed. New Central Book Agency Ltd. Kolkata.2017;17:219-27.
Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP. Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction. Am J Physiol Heart Circ Physiol. 2008;294:541-50. DOI: https://doi.org/10.1152/ajpheart.01113.2007
Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. J Pregnancy. 2012;2:586578. DOI: https://doi.org/10.1155/2012/586578
Kamath SA. Hypertension in pregnancy. JAPI. 2006;54:260-70.
Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Preg. 2011;1:481095. DOI: https://doi.org/10.1155/2011/481095
Rastogi A. Preeclampsia. National Health Portal. 2016.
Lockwood CJ. ACOG task force on hypertension in pregnancy. Contemporary Ob/Gyn. 2013 1;58(12):10.
Dashora S, Sharma R.A Prospective study on platelet counts-a prognostic marker to predict the feto-maternal outcome in pre-eclampsia and eclampsia. Int Arch BioMed Clin Res. 2017;3:37-40.
Siddiqui RP, Chandrakar K, Varma R, Shrivastava S. Study on Platelet Indices in Pregnancy Induced Hypertension. J Evid based Med Healthcare. 2012;5:8035-40. DOI: https://doi.org/10.18410/jebmh/2015/1079
Alkholya EAM, Faragç EA, Beheryñ MA, Ibrahima MM. The significance of platelet count, mean platelet volume and platelet width distribution in preeclampsia. AAMJ. 2013;11:200–14.
Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematol Transfus Cell Ther. 2019;41(2):129-33. DOI: https://doi.org/10.1016/j.htct.2018.08.008
Dhakre R, Nandmer GK, Sapkal R. Correlation of platelet indices with severity of preeclampsia: a prospective study from central India. Int J Reprod Contracept Obstet Gynecol. 2018;7:1416-20. DOI: https://doi.org/10.18203/2320-1770.ijrcog20181327
Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: hospital-based study. J Assoc Phy India. 2006;54:273-8.
Umezuluike BS, Anikwe CC, Nnachi OC, Iwe BC, Ifemelumma CC, Dimejesi IB. Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study. Heliyon. 2021;7(12):8484. DOI: https://doi.org/10.1016/j.heliyon.2021.e08484
Gupta A, Gaur BS, Mishra KB, Dubey I. A comparison of platelet counts in severe preeclampsia, mild preeclampsia, and normal pregnancy. Int J Res Med Sci. 2018;6:671-6. DOI: https://doi.org/10.18203/2320-6012.ijrms20180318
Amita K, Nithin KH, Shobha SN, Vijay S. The role of platelet parameters as a biomarker in the diagnosis and in predicting the severity of preeclampsia. Indian J Pathol Oncol. 2015;2(2):57-60.
Han L, Liu X, Li H, Zou J. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One. 2014;9(12):114488. DOI: https://doi.org/10.1371/journal.pone.0114488
Vijaya C, Lekha MB, Shetty A, Geethamani V. Evaluation of platelet counts and platelet indices and their significant role in pre-eclampsia and eclampsia. J Evol Med Dent Sci. 2014;3(12):3216-20. DOI: https://doi.org/10.14260/jemds/2014/2269
Freitas LG, Alpoim PN, Komatsuzaki F, Carvalho MD, Dusse LM. Preeclampsia: are platelet count and indices useful for its prognostic. Hematology. 2013;18(6):360-4. DOI: https://doi.org/10.1179/1607845413Y.0000000098
Tesfay F, Negash M, Alemu J, Yahya M, Teklu G, Yibrah M, et al. Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia. Plos one. 2019;14(11):225536. DOI: https://doi.org/10.1371/journal.pone.0225536
Reddy SG, Rajendra Prasad CS. Significance of platelet indices as severity marker in nonthrombocytopenic preeclampsia cases. J Lab Phys. 2019;11:186-91. DOI: https://doi.org/10.4103/JLP.JLP_161_18