Role of platelet distribution width and plateletcrit in assessment of nonthrombocytopenic preeclampsia and eclampsia in a tertiary care hospital of Odisha: an observational study

Abstract

Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.

Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.

Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.

Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.