DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201795

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

Kirtirekha Mohapatra, Pranati Mohanty, Nahida Nigar Sultana

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.


Keywords


Eclampsia, Plateletcrit, Platelet distribution width, Platelet indices, Preeclampsia

Full Text:

PDF

References


Abass AE, Abdalla R, Omer I, Ahmed S, Khalid A, Elzein H. Evaluation of platelets count and indices in pre-eclampsia compared to normal pregnancies. IOSR J Dent Med Sci (IOSR-JDMS). 2016;1(15):5-8.

Halligan A, Bonnar J, Sheppard B, Darling M, Walshe J. Haemostatic, fibrinolytic and endothelial variables in normal pregnancies and pre‐eclampsia. BJOG: An Inter J Obstet Gynaecol. 1994;101(6):488-92.

Kawthalkar SM. Essentials of clinical pathology. Clinical chemistry and other laboratory test. Second edition Jaypee Brothers, Medical Publishers Pvt. Limited; 2018.

Briggs C, Harrison P, Machin SJ. Continuing developments with the automated platelet count 1. Inter J Lab Hematol. 2007;29(2):77-91.

Singh A, Varma R. Role of platelet distribution width (PDW) and plateletcrit in the assessment of nonthrombocytopenic preeclampsia and eclampsia. The J Obstet Gynecol India. 2018;68(4):289-93.

Chandrashekar V. Plateletcrit as a screening tool for detection of platelet quantitative disorders. J Hematol. 2013;2(1):22-6.

Vladareanu AM, Andrei C, Onisai M. The endothelial-platelet dysfunction in preeclampsia. Maed J Clin Med. 2007;2(3):214-21.

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.

Buchbinder A, Sibai BM, Caritis S, MacPherson C, Hauth J, Lindheimer MD, et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002;186(1):66-71.

AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vas Health Risk Manag. 2016;12:477.

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?. Hyper Preg. 2015;34(4):434-42.

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.

Giles C. The platelet count and mean platelet volume. Br J Haematol. 1981;48(1):31-7.

Dadhich S, Agrawal S, Soni M, Choudhary R, Jain R, Sharma S, et al. Predictive value of platelet indices in development of preeclampsia. J SAFOG. 2012;4(1):17-21.

Şahin F, Yazar E, Yıldız P. Prominent features of platelet count, plateletcrit, mean platelet volume and platelet distribution width in pulmonary tuberculosis. Multidis Respirat Med. 2012;7(1):38.

Kadikoylu G, Yavasoglu I, Bolaman Z, Senturk T. Platelet parameters in women with iron deficiency anemia. J Nat Med Associat. 2006;98(3):398.

Cetin MS, Cetin EH, Akdi A, Aras D, Topaloglu S, Temizhan A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiologia Polska (Poli Heart J). 2017;75(10):1005-12.