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PLATELET COUNTS IN PREGNANT WOMEN WITH PREECLAMPSIA
Das Sharodiya
1
D.B.Mirzaeva
2
1
Student of International faculty, Tashkent Medical Academy, Uzbekistan
2
PhD,Department of Obstetrics and gynecology, Tashkent Medical Academy,
Uzbekistan.
https://doi.org/10.5281/zenodo.14987019
Introduction.
Preeclampsia (PE) is a pregnancy-related complication
leading to development of acute hypertensive condition that still continues to be
a major concern for Obstetricians. Platelets play a key role in its pathogenesis
since their activation leads to increased consumption and abnormal values,
which can be used as markers of disease progression. Mean platelet volume
(MPV) and platelet distribution width (PDW) are also the most important
markers of platelet heterogeneity. Elevated MPV reflects the size of more active
larger platelets, and elevated PDW reflects enhanced platelet heterogeneity,
both of which have been linked to vascular function in preeclampsia. Although
the platelet indices have been mentioned in the context of hypertensive
disorders, there is still no finding of how they forecast severity and
complications in PE.
The aim of this study
is to assess platelet indices in preeclampsia and
determine their correlation with the severity of the disease, highlighting their
prognostic significance.
Materials and Methods.
Study Design and Population: Case-control study
was conducted at Maternity hospital 3, Tashkent Medical Academy, enrolling 58
pregnant women into: two groups. Preeclampsia group (n=28): Classified
according to ISSHP criteria. Divided into mild (n=15) and severe (n=13) cases.
Control group (n=30): Age-matched normotensive pregnant women without
proteinuria.
Platelet indices (PC, MPV, PDW) were added to CBC. Statistics were
calculated using SPSS and Ms-excel.
Result.
We studied the average age of patients in all study groups. The
average age of patients in the main group was 27,0±2,8, in the control group
27,2±3,7 years (p=0,078). The average age of patients did not differ in the
average statistical ratio. This can be concluded that hypertensive conditions of
pregnant women can occur in any age category, and has no age-specific values.
When studying the gestational periods of pregnant women, no statistically
significant indicators (p=0,84) were identified. Platelet indices, namely platelet
count, mean platelet volume, platelet distribution width, and plateletcrit, were
evaluated in both cases and controls. None of the patients had any evidence of
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
21
thrombosis or organ damage. The PT/INR was within the normal range. Thus, all
the patients included in the study had mild to moderate preeclampsia. A study of
the platelet counts (×10⁹/l) at different weeks of pregnancy in the examined
groups revealed different indicators. The average platelet count in the main
group was 270,0±11,4×10⁹/L at 20–24 weeks, 200,0±14,2×10⁹/L at 25–29
weeks and 195,5±13,9×10⁹/L at 30–34 weeks, in the control group it was
275,0±10,2×10⁹/L at 20–24 weeks, 280,0±12,5×10⁹/L at 25–29 weeks and
278,0±11,8×10⁹/L at 30–34 weeks. The platelet count was on the lower side in
the patients with preeclampsia, as compared to the healthy pregnant females,
however none of the patients had severe thrombocytopenia. In our study, the
difference with statistically significant p>0,05 was found in pregnant women at
20-24 weeks (p=0,08). But
Drop in platelet count in 25 to 34 weeks is
significantly correlated in control and case group (р<0,001).
The mean platelet volume (MPV) in pregnant women showed statistically
significant signs (p<0,05) at all gestational weeks of pregnancy. MPV was
increased in women with preeclampsia compared to healthy pregnant women.
The difference between the main group and the control group was statistically
significant (p<0,001). The average Mean Platelet Volume (MPV) in the main
group was 11,4±0,6fL at 20–24 weeks, 11,9±0,7fL at 25–29 weeks and
12,1±0,6fL at 30–34 weeks, in the control group it was 9,6±0,5fL at 20–24
weeks, 9,8±0,6fL at 25–29 weeks and 9,9±0,5fL at 30–34 weeks. The correlation
coefficient r had a value of +0,42, indicating a positive correlation. Thus, it can be
assumed that the increase in MPV values is directly proportional to the increase
in blood pressure. And it can be found that the longer the gestation period, the
higher the MPV values in pregnant women (p<0,001). Similarly, platelet
distribution width (PDW) increased in preeclampsia group when compared to
normotensive pregnant women (p<0,001). The median value of the PDW was
16,9 fl in preeclampsia and 14,6 in normotensive patients, respectively and the
difference was statistically significant (p<0,05), with higher values in
preeclampsia.
Conclusion.
The importance of the tremendous changes in the platelet indices
in preeclampsia and their potential use as disease severity surrogate markers on
the basis of MPV and PDW is highlighted through this study. The high coefficient
of correlation with systolic BP of MPV makes it an important clinical value in
predicting the vascular dysfunction to come. The study highlights the potential
of platelet indices to be used as a biomarker in in routine prognosis in the
treatment of preeclampsia.
