DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180150

Effect of pregnancy on packed cell volume and total white blood cells count among Sudanese pregnant women attending antenatal care at Ribat University Hospital (Khartoum state)

Wafa Mubarak M. Ahmed, Abdurrahman Khalid, O. A. Musa

Abstract


Background: During pregnancy the women undergo several structural and physiological changes almost in all body systems including the hematological profile. The main reported hematological change is the plasma expansion and haemodilution which affect the red blood cells(RBCs) and white blood cells (WBCs) count in addition to other hematological indices including packed cell volume (PCV). The objective of this study was to assess the effect of pregnancy on packed cell volume and white blood cells among Sudanese pregnant women and derive a formula for the normal values in pregnant women in relation to the packed cell volume.

Methods: An analytical case control study was conducted in Khartoum state, Sudan 2017. The study included20 Sudanese pregnant women in the second and third trimesters attending the antenatal care at The National Ribat university hospital and 20 Sudanese non-pregnant women in the same age group as control. A questionnaire was used to collect socio-demographic and clinical data.5ml of venous blood was collected in a container containing EDTA. Complete blood count (CBC) was measured by using automated cell counter Sysmex.

Results: There was statistically significant decrease in PCV value during 2nd and 3rd trimesters of pregnancy compared to the non-pregnant control group with p values (0.00 and 0.04 respectively), and statistically significant increase in WBCs count during 2nd and 3rd trimesters of pregnancy compared to the non-pregnant control group with p values (0.04 and 0.00 respectively). Also, a progressive increase in WBCs count with gestational age was demonstrated (second trimester 6.65×103/uL, third trimester 7.43×103/uL). The results showed mean WBCs of 7.79×103/uL, when compared to the estimated values the results showed no significant difference with the mean WBCs in 2ndand 3rdtrimesters (p value 0.06 and 0.39 respectively).

Conclusions: During pregnancy there was statistically significant decrease in PCV values, statistically significant increase in WBCs count and by considering the haemodilution factor there was a higher increase in WBCs count.


Keywords


Haemodilution, PCV, Sudanese pregnant women, WBCs

Full Text:

PDF

References


Surabhi Chandra, Anil Kumar Tripathi, Sanjay Mishra, Mohammad Amzarul, and Arvind Kumar Vaish: Physiological Changes in Hematological Parameters During Pregnancy. Indian J Hematol Blood Transf. 2012;28(3):144-6.

Purohit G, Shah T, Harsoda JM. Hematological profile of normal pregnant women in Western India. Scholars J Appl Med ScI. 2015;3(6A):2195-9.

Akinbami AA, Ajibola SO, Rabiu KA, Adewunmi AA, Dosunmu AO, Adediran A ET AL. Hematological profile of normal pregnant women in Lagos, Nigeria. Int J Women’s Health. 2013;5:227-32.

Anberbir S, Hussein M, Tibebu M. Hematological profile of pregnant women attending antenatal care at Dilla University Referral Hospital, Dilla, Ethiopia: comparative cross sectional study. MSc research. October, 2016.

Grathwohl KW, Bruns BJ, LeBrun CJ, Ohno AK, Dillard TA, Cushner HM. Does hemodilution exist? Effects of saline infusion on hematologic parameters in euvolemic subjects. Southren Med J. 1996 Jan;89(1):51-5.

Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016 Mar-Apr; 27(2):89-94.

Miller JR, Keith NM, Rowntree LG. Plasma and blood volume in pregnancy. JAMA. 1915 Aug 28;65(9):779-82.

Elmugabil A, Rayis DA, Abdelmageed RE, Adam I, Gasim GI. High level of hemoglobin, white blood cells and obesity among Sudanese women in early pregnancy: a cross-sectional study. Future Sci OA. 2017 Apr 4;3(2):FSO182.

Van Buul EJ, Steegers EA, Jongsma HW, Eskes TK, Thomas CM, Hein PR. Hematological and biochemical profile of uncomplicated pregnancy in nulliparous women. Netherlands J Medic. 1995;46(2):73-85.

Hossain N, Paidas MJ. Hematologic Changes in Pregnancy. Research Gate. March 2011. Available at https://www.researchgate.net/publication/227697211_Hematologic_Changes_in_Pregnancy

James TR, Reid HL, Mullings AM. Are published standards for haematological indices in pregnancy applicable across populations: an evaluation in healthy pregnant Jamaican women. BMC Pregnancy Childbirth. 2008 Feb 28;8(1):8.

James TR, Reid HL, Mullings AM. Are published standards for haematological indices in pregnancy applicable across populations: an evaluation in healthy pregnant Jamaican women. BMC pregnancy and childbirth. 2008 Feb 28;8(1):8.

Faupel-Badger JM, Hsieh CC, Troisi R, Lagiou P, Potischman N. Plasma volume expansion in pregnancy: implications for biomarkers in population studies. Cancer Epidemiol Biomarkers Prevent. 2007 Sep;16(9):1720-3.

Mohamed AO, Hamza KM, Babker AM. Physiological changes in some hematological and coagulation profile among Sudanese healthy pregnant women. Int J Med Sci Public Health. 2016 Mar 1;5:525-8.

Abass RE, Omballi MM, Osman MI. Assessment of complete blood count in Sudanese pregnant women in different trimesters in Khartoum State. Eur Academic Res. 2016;IV(7):5960-4.

Milman N, Bergholt T, Byg KE, Eriksen L, Hvas AM. Reference intervals for haematological variables during normal pregnancy and postpartum in 434 healthy Danish women. Eur J Haematol. 2007 Jul;79(1):39-46.

Goswami TM, Patel VN, Pandya NH, Mevada AK, Desai KS, Solanki KB. Maternal anaemia during pregnancy and its impact on perinatal outcome. Int J Biomed Adv Res. 2014;5(02):99-102.

Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for leukocytosis in women with preeclampsia. Am J Perinatol. 2009 Nov;26(10):729-32.

Pughikumo OC, Pughikumo DT, Omunakwe HE. White blood cell counts in pregnant women in Port Harcourt, Nigeria. IOSR-JDMS. 2015;14(3):01-03.

Pitkin RM, Witte DL. Platelet and leukocyte counts in pregnancy. Jama. 1979 Dec;242(24):2696-8.