DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20214342
Published: 2021-10-27

A cross sectional study of coagulation profile in term normotensive pregnancy and hypertensive disorders like preeclampsia, eclampsia

Madana Jyotsna Priya, Gomathy Ethiraj, Sheela Shivamonga Rangappa

Abstract


Background: Normal pregnancy is a procoagulant state. In preeclampsia, this process of coagulation is exaggerated and will lead to further effects on the mother, placenta and fetus. The purpose of this study is to find out the changes that occur in the coagulation indices in pregnancy induced hypertension as compared to that in normal pregnancy which will help in the better management of patients with pregnancy induced Hypertension.

Methods: This was a cross sectional study in 116 patients with normotensive and patients with hypertensive disorders in pregnancy conducted in a tertiary medical facility. Coagulation parameters like platelet count, prothrombin time, activated partial thromboplastin time, bleeding time and clotting time were evaluated. We used the difference of 5% in mean PT between normotensive (control) and hypertensive patients by applying 80% power and alpha error of 5%.

Results: Platelet counts of study population were significantly related to the prognosis of the patient. The cut off values of major parameters like aPtt, BT with the outcome were with p value of 0.37 and 0.76 respectively.

Conclusions: In cases of pregnant complicated with HDP, parameters like coagulation profile, bleeding time, clotting time were probably useful indicators in the early diagnosis and management of severe morbidity of the mother and the fetus. Further prospective trials with large study population are warranted to evident these results.


Keywords


Coagulation profile, Hypertensive disorders in pregnancy, HELLP syndrome

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References


Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130-137.

Steegers EA. von Dadelszen P. Duvekot. Pre eclampsia. Lancet. 2010;37:6631-44.

Wallis AB, Safilas AF. Hsia J. Secular Trends in the rate of preeclampsia, eclampsia. and gestational hypertension, United States, 1987-2004. Am J Hypertens. 2008;21:521-6.

Mishra DP, Choudhury S, Tudu B. Evaluation of coagulation indices in preeclampsia and eclampsia. J Evid Based Med Health. 2019;6(17):1316-20.

Ohad F. The association between abnormal coagulation testing in preeclampsia, adverse pregnancy outcomes and placental histopathology. Hypertens Preg. 2019;38(3):176-183.

Priyanka C, Usha R, Vandana B. Purohit RC. Comparison of coagulation profile in preeclamptic and eclamptic patients with normotensive pregnant patients. J Evol Med Dent Sci. 2014;3(12):3208-15.

Mol B. Preeclampsia. Lancet. 2016;387:999-1011.

Swetha AG, Puranik N, Kammar KF. A comparative study on coagulation profile and neutrophil – lymphocyte ratio in pregnancy induced hypertension. Nat J Physiol Pharma Pharmacol. 2018;8(3):400-5.

Buchbinder A, Sibai BM, Caritis S. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002;186:66-71.

Xiao R, Sorensen TK, Williams WA. Influence of pre-eclampsia on fetal growth. J Matern Neonatal Med. 2003;13:157-62.

Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies. Obstet Gynecol. 2009;114:1326-31.

Leduc L, Wheeler JM, Kirshon B. Coagulation profile in severe preeclampsia. Obstet Gynecol. 1992;79:14-8.

Barron WM, Heckerling P, Hibbard JU. Reducing unnecessary coagulation testing in hypertensive disorders of pregnancy. Obstet Gynecol. 1999;94:364-70.

American college of obstetricians and gynecologists bulletin. Gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133:1-25.

Han L, Liu X, Li H. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One. 2014;9:e114488.