Platelet count as a first line screening test for the detection of coagulation disorder in preeclamptic and eclamptic patients
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262086Keywords:
Coagulation disorder, Eclampsia, Platelet count, Pre-eclampsia, Screening testAbstract
Background: Pre-eclampsia and eclampsia are major obstetric complications and important causes of maternal morbidity and mortality in developing countries. Platelet count is a simple, inexpensive, and widely available investigation that may help detect coagulation disorders in these conditions. This study aimed to determine the sensitivity and specificity of platelet count for predicting coagulation disorders in pre-eclampsia and eclampsia.
Methods: This cross-sectional analytical study was conducted in the department of obstetrics and gynecology of Dhaka Medical College Hospital from June 2022 to May 2023. A total of 81 pregnant women were enrolled and divided equally into three groups: pre-eclampsia (n=27), eclampsia (n=27), and normotensive pregnancy (n=27). Platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), serum fibrinogen, and D-dimer were measured. Data were analyzed using SPSS version 26.
Results: Mean platelet count was significantly lower in eclampsia (186,296.3±91,728.6/μl) and pre-eclampsia (217,777.8±77,745.3/μl) compared to normal pregnancy (252,296.3±44,155.2/μl) (p<0.001). Thrombocytopenia was observed in 38.89% of pregnancy-induced hypertension cases. For detecting coagulation disorders, platelet count showed sensitivity of 45.45% and specificity of 90.00% in eclampsia, while sensitivity and specificity in pre-eclampsia were 46.51% and 81.82%, respectively.
Conclusions: Platelet count alone is not a reliable screening test for coagulation disorders in pre-eclampsia and eclampsia.
References
Chaware SA, Dhake R, Ingole AS, Bahattare VN, Bhopale KS. Study of coagulation profile in Preeclampsia and Eclampsia. Int Med J. 2015;2(3):164-70.
OGSB. Standard clinical management protocols and flowcharts on emergency obstetric and neonatal care 2019. Available from: https://file-chittagong.portal.gov.bd/uploads/6b9a9df8-2650-4326-bbfd-55418d77e00d//66d/6ef/0b1/ 66d6ef0b196fa815778442.pdf. Accessed on 11 February 2026.
Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275-89.
Abd El-Rahman S, Sonosy DA, Abbas AM, Abdou MA. Evaluation of platelet count and platelet indices in the diagnosis of preeclampsia and eclampsia: a cross-sectional study. J Women’s Health Res. 2020;101(1).
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.
Trogstad L, Magnus P, Stoltenberg C. Pre-eclampsia: risk factors and causal models. Best Pract Res Clin Obstet Gynaecol. 2011;25(3):329-42.
Rebarber A. Hypertensive disorders of pregnancy. Evid Based Obstet Gynecol. 2019;225-264.
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.
Holthe MR, Staff AC, Berge LN, Lyberg T. Different levels of platelet activation in preeclamptic, normotensive pregnant, and nonpregnant women. Am J Obstet Gynecol. 2004;190(4):1128-34.
Onisai M, Vasilache V. The endothelial-platelet dysfunction in pre-eclampsia. Mædica J Clin Med. 2007;2(3):214.
Konijnenberg A, Stokkers EW, van der Post JA, Schaapb MC, Boer K, Bleker OP, et al. Extensive platelet activation in preeclampsia compared with normal pregnancy: enhanced expression of cell adhesion molecules. Am J Obstet Gynecol. 1997;176(2):461-9.
McCrae KR. Thrombocytopenia in pregnancy. Hematology 2010, the American Society of Hematology Education Program Book. 2010;2010(1):397-402.
Pishko AM, Levine LD, Cines DB. Thrombocytopenia in pregnancy: Diagnosis and approach to management. Blood Rev. 2020;40:100638.
Shehata N, Burrows R, Kelton JG. Gestational thrombocytopenia. Clin Obstet Gynecol. 1999;42:321-5.
Sultana R, Karim SF, Atia F, Ferdousi S, Ahmed S. Platelet count in preeclampsia. J Dhaka Nat Med Coll Hosp. 2012;18(2):24-6.
Packer CS. Biochemical markers and physiological parameters as indices for identifying patients at risk of developing pre-eclampsia. J Hypertens. 2005;23(1):45-6.
Javed A, Yasmeen N, Shafiq L. Low platelets counts as a predictor and pre-eclampsia in high risk pregnant females. PJMHS. 2020;14:1.
Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: hospital based study. J Assoc Phys India. 2006;54:273-8.
Lewandowska M, Więckowska B, Sajdak S. Pre-pregnancy obesity, excessive gestational weight gain, and the risk of pregnancy-induced hypertension and gestational diabetes mellitus. J Clin Med. 2020;9(6):1980.
Gupta A, Gaur BS, Mishra KB, Dubey I. A comparison of platelet count in severe preeclampsia, mild preeclampsia and normal pregnancy. Int J Res Med Sci. 2018;6(2):671.
Sameer MA, Meshram DP, Deshpande SA, Sadhu D, Pandit S. Role of platelet count as important prognostic marker in pregnancy induced hypertension. IOSR J Dent Med Sci. 2014;13:39-43.
Prieto JA, Mastrobattista JM, Blanco JD. Coagulation studies in patients with marked thrombocytopenia due to severe preeclampsia. Am J Perinatol. 1995;12(03):220-2.