Platelet count as a prognostic indicator in pregnancy induced hypertension
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20160854Keywords:
Pregnancy induced hypertension, ThrombocytopeniaAbstract
Background: Hypertensive disorders are most common medical complications of pregnancy, and are one of the major causes of maternal and fetal morbidity and mortality. Thrombocytopenia complicating hypertensive disorders of pregnancy are responsible for approximately 20% of all cases of thrombocytopenia during pregnancy.
Our study was done to assess the utility of platelet count as a prognostic indicator in pregnancy induced hypertension to recognize and manage early the complications arising and to have a better pregnancy outcome.
Methods: This study includes 76 cases of pregnancy induced hypertension over a period of 18 months. Platelet estimation was done for all cases and patients with documented platelet count of less than 1,50,000/cumm was documented as thrombocytopenia.
Results: Of the 76 cases of pregnancy induced hypertension, 32 (42.1%) were diagnosed with thrombocytopenia, and an increased incidence of maternal and fetal morbidity & mortality was observed.
Conclusions: Our study and the results show that the assay of platelets can be considered as one of the prognostic tool in management of hypertensive disorders of pregnancy.References
Mohapatra S, Pradhan BB, Satpathy UK, Mohanty A, Pattnaik JR. Platelet estimation: Its prognostic value in pregnancy induced hypertension. Indian J Physiol Pharmacol. 2007;51(2):160-4.
McCrae KR. Pregnancy induced thrombocytopenia: pathogenesis and management. Blood. 1992;80;2697-714.
Charo IF, Kieffer N. Platelet membrane glycoproteins. Hemostasis and thrombin; Basic principles and clinical practice, Philadelphia: JB Lippincott co. 1994;489-507.
Lee GR, Fester J. Thrombocytopenia pathophysiology and classification. Wintrobe’s clinical hematology. 10th edition. Philadelphia: lippincott Williams & Wilkins. 1999:1579-1611.
Rodgers RPC, Levin J. A critical reappraisal of bleeding time. Sem throm hemost. 1990;16:1-144.
Kumar V, Abbas AK. Pathologic basis of disease. Diseases of immune system. 8th edition. 2007;5:111-34.
Branchog I. Platelet enemal and platelet production in ITP. British Journal of Hematology. 1974;27:127-43.
Harker LD. Thrombo kinelin in man. J. Clin invest. 1969;48:963-74.
Meaell JS. Antenatal management of thrombocytopenias. Clin perinatal. 1994;21:591-614.
Greer IA. A prospective longitudinal study of immuno reactive prostacyclin and TX-A2 metabolites in normotensive and hypertensive pregnancy. Clinical and experimental hypertension. Part B: hypertension in pregnancy. 1985;4:167-81.
Gowland E. Agglutination of platelets by a serum factor in the presence of EDTA. J. Clinicopathol. 1969;22:460-64.
Kield, Berg CR. Spurious thrombocytopenia. JAMA. 1974;227:628-30.
Burrows RF. Fetal thrombocytopenia and its relationship to maternal thrombocytopenia. N. Engl J Med. 1993;329:1463-6.
Burrows RF. Low fetal risks in pregnancies associated with idiopathic thrombocytopenic purpura. Am J Obstetrics & Gynecol. 1990;163:1147-50.
Kenton JG. The serological investigation of patients with autoimmune thrombocytopenia. Thromb hoemost. 1995;74:228-33.
Berchtold. Autoantibodies against platelet glycoproteins in autoimmune thrombocytopenic purpura, their clinical significance and response to treatment. Blood. 1993;81:1246-50.
Kruayenbrink AA. Endothelial vasoactive mediation in pre eclampsia. Am J Obstet Gynecol. 1993;169:160-3.
Barton JR. Care of pregnancy complicated by HELLP syndrome. Clin N Am. 1991;18:165-79.
Audibert F. Clinical utility of strict diagnostic criteria for HELLP syndrome. Am J Obst Gynecol. 1996;175:460-64.
Sibai BM. Pregnancies complicated by HELLP syndrome, subsequent pregnancy outcomes, long term prognosis. Am J Obst Gynecol. 1995;172:125-9.
Visser W. Management of severe pre eclampsia with and without HELLP syndrome. Br J obstet & gynecol. 1995;102:111-7.
Romero R. Clinical significance, prevalence and natural history of thrombocytopenia in pregnancy induced hypertension. Am J perinatal. 1989;6:32-8.
Prichart JA. Coagulation changes in eclampsia: their frequency and pathogenesis. Am J Obstet Gynecol. 1976;4:855-64.
Redman CW. Early platelet consumption in pre-eclampsia. Br J med. 1978;70:334-8.
Galton M. Coagulation studies on the peripheral circulation of patients with toxemia of pregnancy. J Reprod med. 1971;6:89-100.
