Published: 2018-12-26

Platelet count and MPV in women with PIH in their third trimester

Suhail Iqbal, Aditi Sharma


Background: One of the most common and potential life-threatening complications of pregnancy is pregnancy induced hypertension. 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 and severity of PIH.

Methods: This prospective study was conducted in the Department of obstetrics and gynecology in Jhalawar medical college from January 2018 to April 2018.Total 120 pregnant women during third trimester (32-40 weeks) aged 18 to 35 years were selected. Among them 63 were preeclamptic patients and 63 were healthy normotensive control. Subjects and healthy pregnant women (control) visiting the Obstetrics and Gynecology department of Jhalawar Medical College were registered in the study and followed during their pregnancy. Both, subjects and control participants were subject to platelet count manually and MPV was determined by an automated analyser (sysmex XN-1000™) performed using standard methods on.

Results: The mean platelet count of the subject group (131.4937±62.05999 lakh/mm3) was significantly lower than that of the control group (324.9683±230.78764 lakh/mm3). This shows that there is thrombocytopenia found in patients with P.I.H in their third trimester. On the other hand, the p value of “mean platelet volume” in patients with preeclampsia was (p<0.0001) which shows that there is no significant difference in MPV of cases (7.1438±2.62 femtolitre) and control (7.8976±3.08 femtolitre) (p>0.142), regular monitoring of platelet counts in women with Pregnancy Induced Hypertension must be subject of the management protocols.

Conclusions: In present study we observed that the number of thrombocytopenic subjects was higher in cases of preeclampsia as compared to the control group. These extrapolations indicate that there might be some important mechanism which interferes with platelets life span thus reducing the number of functional platelets in circulation. The platelet count has an association at prediction of increasing grade of PIH. There is an inverse relationship between the severity of PIH and platelet count. The depleted platelet counts are concluded to be consistently associated with clinical groups of severe preeclampsia and the risk of consumptive coagulopathy.


fL (femtolitre), Hypertension, MPV (Mean platelet volume), Platelet count, Pregnancy

Full Text:



Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365(9461):785-99.

De Boer K, ten Cate JWn Sturk A, Borm JJ, Treffers PE. Enhanced thrombin generation in normal and hypertensive pregnancy. Am J Obstet Gynecol. 1989;160(1):95-100.

Prisco D, Cluti G, Falciani M. Haemostatic changes in normal pregnancy. Hematol Rep. 2005;1(10):1-5.

Ellenson LH, Pirog EC. The female genital tract. In: Kumar V, Abbas A, Fausto N, Aster J, editkors. Robbins and Cotran Pathologic basis of disease. 8th ed. Philadelphia (PA): Saunders Elsevier; 2010:1055-1056.

Redman CW. Current topic: pre-eclampsia and the placenta. Placenta. 1991;12(4):301-8.

Burrows RF, Hunter DJ, Andrew M, Kelton JG. A prospective study investigating the mechanism of thrombocytopenia in preeclampsia. Obstet Gynaecol. 1987;70(3 Pt 1):334-8.

Vamseedhar A, Srinivasa K, Santhosh K Yatnatti, Suresh DR. Evaluation of platelet indices and platelet counts and their significance in preeclampsia and eclampsia. Int J Biol Med Res. 2011;2(1):425-8.

Romero R, Mazor M, Lockwood CJ, Emamian M, Belanger KP, Hobbins JC et al. Clinical significance, prevalence, and natural history of thrombocytopenia in pregnancy-induced hypertension. Am J Perinatol. 1989;6(1):32-8.

Shaper AG, Kear J, Macintosh DM, Kyobe J, Njama D. The platelet count,platelet adhesiveness and aggregation and the mechanism of fibrinolytic inhibition in pregnancy and the puerperium. J Obstet Gynaecol Br Commonw. 1968;75(4):433-41.

Wallenburg HC, van Kessel PH. Platelet lifespan in normal pregnancy as determined by a nonradioisotopic technique. Br J Obstet Gynaecol. 1978;85(1):33-6.

Sill PR, Lind T, Walker W. Platelet values during normal pregnancy. Br J Obstet Gynaecol. 1985;92(5):480-3.

Gerbasi FR, Bottoms S, Farag A, Mammen E. Increased intravascular coagulation associated with pregnancy. Obstet Gynecol. 1990;75(3 Pt 1):385-9.

Adam GK, Bakheit KH, Adam I. Maternal and perinatal outcomes of eclampsia in Gadarif Hospital, Sudan. J Obs Gynaecol. 2009;29(7):619–620.

Redman Christopher W, Sargent Ian L. Latest advances in understanding preeclampsia. Sci.2005;308(5728):1592-4.

Walker JJ. Pre-eclampsia. Lancet (London, England). 2000;356(9237):1260-5.

Anderson UD, Olsson MG, Kristensen KH, Åkerström B, Hansson SR. Review: biochemical markers to predict preeclampsia. Placenta. 2012;33:S42-7.

Burton GJ, Woods AW, Jauniaux E, Kingdom JCP. Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta. 2009;30(6):473-82.

Burton GJ, Charnock-Jones DS, Jauniaux E. Regulation of vascular growth and function in the human placenta. Reproduct. 2009;138(6):895-902.

Maynard SE, Karumanchi SA. Angiogenic factors and preeclampsia. Semin Nephrol. 2011;31(1):33-46.

Juan P, Stefano G, Antonella S, Albana C. Platelets in pregnancy. J Prenat Med. 2011;5(4):90-2.

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

Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. J Clin Lab Anal. 2012;26(5):403-6.

Dundar O, Yoruk P, Tutuncu L, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008;28(11):1052-6.

Freitas LG, Alpoim PN, Komatsuzaki F, Carvalho Md, Dusse LM. Preeclampsia: are platelet count and indices useful for its prognostic? Hematol. 2013;18(6):360-4.

Kashanian M, Hajjaran M, Khatami E, Sheikhansari N. Evaluation of the value of the first and third trimester maternal mean platelet volume (MPV) for prediction of pre-eclampsia. Pregnancy Hypertens. 2013;3(4):222-6.

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? Hypertens Pregnancy. 2015;34(4):434-42.

Han L, Liu X, Li H, Zou J, Yang Z, Han J, et al. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One. 2014;9(12):e114488.

Kanat-Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil-Koken G, Yilmazer M. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014;40(7):1840-5.

Karateke Atilla, Kurt Raziye Keskin, Baloğlu Ali. Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia. Ginekol Pol. 2015;86(5):372-5.

Moraes D, Munhoz TP, Pinheiro da Costa BE, et al. Immature platelet fraction in hypertensive pregnancy. Plat. 2016;27(4):333-7.

Özdemirci Ş, Başer E, Kasapoğlu T, Karahanoğlu E, Kahyaoglu I, Yalvaç S. Predictivity of mean platelet volume in severe preeclamptic women. Hypertens Pregnan. 2016;35(4):474-82.

Vilchez G, Londra L, Hoyos LR, Sokol R, Bahado-Singh R. Intrapartum mean platelet volume is not a useful predictor of new-onset delayed postpartum pre-eclampsia. Int J Gynaecol Obstet. 2015;131(1):59-62.

Yavuzcan A, Caglar M, Ustun Y, Dilbaz S, Yidiz E, Ozbilgec S, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197-203.

ACOG technical bulletin. Hypertension in pregnancy. Number 219 – January 1996 (replaces no. 91, February 1986). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1996;53(2):175-83.

ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 2002;77(1):67-75.

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. Eur J Obstet Gynecol Reprod Biol. 2014;175:107-11.

Makuyana D, Mahomed K, Shukusho FD, Majoko F. Liver and kidney function tests in normal and pre-eclamptic gestation – a comparison with non-gestational reference values. Cent Afr J Med. 2002;48(5–6):55-9.

Ceyhan T, Beyan C, Başer I, Kaptan K, Güngör S, Ifran A. The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol. 2006;85(5):320-2.

He Y, Xu B, Song D, Yu F, Chen Q, Zhao M. Correlations between complement system’s activation factors and anti-angiogenesis factors in plasma of patients with early/late-onset severe preeclampsia. Hypertens Pregnancy. 2016 35(4):499-509.