Platelet count estimation: a prognostic index in pregnancy induced hypertension

Authors

  • Aakriti Gupta Department of Obstetrics and Gynecology, GMC, Jammu, Jammu and Kashmir, India
  • Jyoti Hak Department of Obstetrics and Gynecology, GMC, Jammu, Jammu and Kashmir, India
  • Isha Sunil Department of Obstetrics and Gynecology, GMC, Jammu, Jammu and Kashmir, India
  • Amita Gupta Department of Obstetrics and Gynecology, GMC, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20180158

Keywords:

Eclampsia, Platelet count, Preeclampsia, Prognostic marker, Thrombocytopenia

Abstract

Background: Hypertension in pregnancy is one of the serious complications of pregnancy with an incidence of 5% to 7% of all pregnancies, particularly in cases with preeclampsia and eclampsia. Though platelet count during pregnancy is within the normal non pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity of the disease process and duration of PIH syndrome.

Methods: A prospective observational study was conducted on 200 pregnant women attending OPD Or Inpatients in the Department of Obstetrics and Gynecology, SMGS Hospital, GMC Jammu from November 2015 to October 2016. Pregnant women beyond 28 weeks gestation of pregnancy are included and divided into two groups i.e. the study and control group. Platelet counts will be done every 4 weeks in controls and weekly in subjects from 28 weeks till delivery.

Results: The mean platelet count observed among cases of mild preecclampsia, severe preeclampsia and ecclampsia was 2.26, 1.63 and 0.99 lakh/mm3 respectively. The difference in mean platelet count among cases and controls was statistically significant. The association of platelet count with severity of different categories of PIH was analysed statistically and was highly significant.

Conclusions: Platelet count is a very important investigation for the antenatal mother having PIH, as it is directly related to maternal and perinatal outcome. Routine and regular monitoring of platelet count can be included in the routine antenatal checkup among the pregnant women with PIH.

References

Redman CW, Sacks GP, Sargent IL. Preeclampsia:an excessive maternal inflammatory respose to pregnancy. Am J Obstet Gynecol. 1998;180(2 Pt 1):499-506.

Sacks GP, Studenta, Sargent K, Redman CW. Normal pregnancy and preeclampsia both produce inflammatory changes in the peripheral blood leucocytes akin to sepsis. Am J Obstet Gynaecol. 1998;179(1):80-6.

Ness RB, Roberts JM. Epidemiology of hypertension. In: Lindereimer M, Roberts JM, Cunningham FG, editors. Chesley’s Hypertensive Disorders in Pregnancy, 2nd ed. Stamford, Connecticut: Appleton & Lange;1999:43-65.

Jan AK, Jamil M. Management of pre-eclmapsia and eclampsia. JPMI. 2000;14(1):7-19.

Karim, Sacher RA. Thrombocytopenia in pregnancy. Curr Hematol Rep. 2004;3(2):128-33.

Heilman L, Rath W, Pollow K. Hemostatic abnormalities in patients with severe preeclampsia. Clin Appl Thromb Hemost. 2007;13:285.

Cunningham FG, Norman FG, Kerneth JL, Lary CG, Hauthe JC, Wenstom KD. Hypertensive disorders in pregnancy. In: Seilis A, Noujaim SR, Davis, Editors. William Obstetrics, International Edn, 21st Ed, New York; McGraw Hill;2001:567-618.

Sibai BM. Hypertension in pregnancy. In: S.G. Gabbe JR Niebyl JL. Simpson editors. Obst normal and problem of pregnancies. 3rd ed, New York:Churchill Livingstone;1996:935-91.

Leduce L, Wheeler JM, Kirshon B, Mitchell P, Cotton DB. Coagulation profile in Severe Preeclampsia. J Obstet Gynaecol. 1992;79(1):14-8.

Sowmaya K, Smitha K, Malathi T, Shivalingaiah N, Kanmani. Platelet count: a prognostic factor for preeclampsia. Int J Sci Res. 2015;4(4):380-2.

Sajith M, Nimbargi V, Modi A, Sunariya R, Pawar A Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. Int J Pharma Sci Res. 2014;5(4):163-170.

Sxena S, Srivastva PC, Thimmaraju KV, Ajaz KM, Dalmia K, Das B. Sch J App Med Sci. 2014:2(6D):3081-6.

Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: hospital based study. JAPI. 2006;54:273-8.

Priyadarshini G, Mohanty RR. Assessment of coagulation profile and its correlation with of preeclampsia in women of Odisha- A comparative cross sectional study. Int J Basic Appl Physiol. 2014;3(1):139-14.

Chaware SA, Dhake R, Ingole AS, Bahattare VN, Bhopale KS. Study of coagulation profile in preeclampsia and eclmapsia. Med Pulse Med J. 2015; 2(3):164-70.

Jambhulkar S, Shrikhandle A, Shrivastava R, Deshmukh K. Coagulation profile in pregnancy induced hypertension. Ind J Hematol Blood Transfus. 2001;19(1):3-5.

Poluri SL, Ramakrishna S. Predictive value of platelet count as a prognostic marker of PIH. Int J Sci Res. 2016;5(10):724-6.

Mohapatra S, Pradhan BB, Satpathy UK, Mohanty A, Pattnaik JR. Platelet Estimation: its prognostic value in PIH. Indian J Physiol Pharmacol. 2007;51(2):160-4.

Joshi KV, Sapre S. Lowered Platelet count: prognostic index in pregnancy induced hypertension. J Obstet Gynecol India. 2004;54(3):235-6.

Agarwal S, Buradkar A. Coagulation studies in toxaemias of pregnancy. J Obstet Gyanecol Ind. 1978:992-6.

Dube B, Bhattacharya S, Dube RB. Blood coagulation profile in Indian patients with Preeclampsia and Eclampsia. Br J Obstet Gynaecol. 1975;82:35-9.

Giles C, Inglis TC. Thrombocytopenia and macrothrombocytosis in gestational hypertension. Br J Obstet Gynecol. 1981;88(11):1115-9.

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Published

2018-01-23

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Original Research Articles