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Presence of thrombocytopenia, increased MPV, increased PDW and increased PLCR in differents study groups
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Background: Preeclampsia and eclampsia are major obstetric problem in developing countries like Bangladesh. It remains an important cause of maternal mortality throughout the world. Objective: To compare the platelet count and platelet indices in pre-eclampsia and eclampsia patients with normal pregnancies was aim of this study. Methods: This cross...
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Objective
We evaluated whether blood pressure and change in blood pressure measurements during pregnancy were associated with eclampsia or pulmonary oedema among women with pre-eclampsia.
Study design:
Observational study of women with eclampsia, pre-eclampsia complicated by pulmonary oedema and pre-eclampsia without end-organ complications (pre-ec...
Citations
... 13,22,24 However, The PLCR of the normotensive group was found to be higher than findings of Ammar et al and Biva et al in Egypt and India respectively and consistent with elevation in pregnancy. 24,25 This was as a result of bone marrow compensation for the rapid turnover of platelets; the release of younger and larger platelets which increase MPV, PDW and PLCR, which were indices of measurements of average platelet size. 26 Differences in sample size, number of controls and type of haematological autoanalyzer may explain the little difference in mean PLCR in this study and other reports. ...
... 26 Differences in sample size, number of controls and type of haematological autoanalyzer may explain the little difference in mean PLCR in this study and other reports. 24,25 Hence, it is important to have baseline values of platelet indices in our environment so as to serve as reference values and also using appropriate study designs that are multicentered with large sample sizes wound be of help. ...
Background: Preeclampsia is the commonest hypertensive disorder of pregnancy It is responsible for a significant maternal and perinatal morbidity and mortality particularly in the developing world like Nigeria. Platelet activation is central to this disease entity. Therefore, platelet indices should be routinely measured to assess the severity of the disease and pregnancy outcome. Objectives: To compare the platelet indices in normotensive and preeclamptic women in University of Ilorin Teaching Hospital, Ilorin. Study design: A prospective case control study of consented subjects who were pregnant women at gestational age of 28 weeks and above diagnosed with preeclampsia that met the study criteria and controls who were consented healthy normotensive pregnant women at the same gestational age who also met the study criteria. Subjects and controls were matched for social status, gestational age and gravidity. Methodology: A total of 140 parturient comprising 70 each from subjects and controls who satisfied the inclusion criteria were recruited for the study by purposive sampling. Subjects and controls were matched for gestational age, gravidity and social status. Social and medical histories of each parturient as well as the blood pressure and platelet indices samples were obtained. The results were analysed using SPSS version 21.0 with appropriate tables and figures generated. Results: Platelet count was lower in the preeclamptic group than the control (155.47 ± 38.68 x 10 3 /µL vs. 232.51 ± 53.79 x 10 3 /µL, p<0.001), while the other platelet indices were higher in preeclamptic group than the control namely; MPV (11.88 ± 1.05fl vs. 10.77 ± 1.22fl, p<0.001), PDW (15.53 ± 2.28fl vs. 13.94 ± 2.25fl, p<0.001) and PLCR (39.89 ± 7.73% vs. 31.81 ± 7.97%, p<0.001). Conclusion: Apact from the pletelet count that was lower in preeclamptic participants all other platelet indices were significantly higher in preeclamptic participants than their normotensive counterparts.
... 13,21,23 However, The PLCR of the normotensive group was found to be higher than findings in Egyptian and Indian studies respectively and consistent with elevation in pregnancy. 23,24 This could be explained by the bone marrow compensation for the rapid turnover of platelets; the release of younger and larger platelets which in turn increase MPV, PDW and PLCR, which are indices used to measure average platelet size. 25 The little difference in mean PLCR in this study and other reports could be explained by differences in sample size, number of controls and type of haematological autoanalyzer. ...
... 25 The little difference in mean PLCR in this study and other reports could be explained by differences in sample size, number of controls and type of haematological autoanalyzer. 23,24 Hence, baseline values of platelet indices in our locality should be known to serve as reference values. The use of appropriate study designs that are multicentered with large sample sizes is also beneficial. ...
Background: Preeclampsia ranks high among the major causes of maternal and perinatal morbidity and mortality especially in low-resource income countries. The evaluation of platelet indices abnormalities which are among the biochemical characteristics of preeclampsia and its severity is minimally investigated in many developing countries including Nigeria. Objectives: To determine the impact of platelet indices on the severity of preeclampsia in University of Ilorin Teaching Hospital, Ilorin. Study design: A prospective case-control study of consented subjects who were pregnant women at gestational age of 28 weeks and above diagnosed with preeclampsia who met the study criteria and controls who were consented healthy normotensive pregnant women at the same gestational age who also met the study criteria. Subjects and controls were matched for social status, gestational age and gravidity. Methodology: A total of 140 parturient comprising 70 each from subjects and controls who satisfied the inclusion criteria were recruited for the study by purposive sampling. Subjects and controls were matched for gestational age, gravidity and social status. Social and medical histories of each parturient as well as the blood pressure and platelet indices samples were obtained. The results were analysed using SPSS version 21.0 with appropriate tables and figures generated. Results: The mean platelet count declined with severity of preeclampsia, while MPV, PDW and PLCR elevated as disease severity increased. The differences in the platelet indices between mild and severe preeclampsia were statistically significant as shown below. The mean platelet count (181.68 ± 44.42 x 10 3 /µL vs 143.46 ± 29.09 x 10 3 /µL, p<0.001), MPV (11.24 ± 0.92fl vs 12.19 ± 0.97fl, p<0.001), PDW (14.99 ± 2.22fl vs 15.78 ± 2.29fl, p<0.001) and PLCR (39.27 ± 7.90% vs 40.19 ± 7.72%, p<0.001). Conclusion: The severity of preeclampsia worsens with increase platelet indices abnormalities. Recommendation: Platelet indices should be routinely assessed in the management of preeclampsia to evaluate the severity and outcome of the disease.
... In this systematic review and meta-analysis, a total of 25 articles were included. Out of 25 articles, three were conducted in China [38, 50,55], four in India [17,[56][57][58], four in Turkey [16,26,27,59], two in Korea [24, 60], two in Saudi-Arabia [61,62], two in Egypt [25,63], two in Sudan [64,65], two were in Ethiopia [66,67] and the other four studies were from Bangladesh [68], Brazil [69], Pakistan [70], and Mexico [28]. Of the included studies, 20 of them expressed the result of the outcome with mean±SD and the rest five [24, 26, 58, 59, 61] expressed the results with median (IQR). ...
... The association was determined by the pooled weighted mean difference. Accordingly, the majority of the included studies showed that PC was significantly lower in PE pregnant women than NT pregnant women [16,17,24,25,50,57,60,61,63,65,66,[68][69][70]. However, some studies showed that PC had not a significant difference between PE and NT pregnant women [26-28, 55, 56, 58, 62, 64]. ...
Background
Preeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups.
Methods
Relevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg’s institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I ² statistics and Egger’s regression test were used to assess heterogeneity and publication bias among included studies, respectively.
Results
A total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 10 ⁹ /L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group.
Conclusions
This systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.
... and 12.9+-1.60 for15 preeclampsia and eclampsia which is comparable with Mondal et al study showing mean MPV 11.5+-0.86 and 12.16+-1.05 ...
Preeclampsia is a hypertensive pregnancy specific multisystem disorder. It requires prompt intervention that may include observation in tertiary care setting and termination of pregnancy either by inducing labour or by caesarian section. To study the variation of platelet counts, platelet indices in preeclampsia and eclampsia Department of Pathology and Gynaecology & Obstetrics Ramakrishna Mission Seva Pratisthan, Vivekananda Institute of Medical Sciences from January 2017 to June 2018. Group I: Women affected with convulsion and having signs of preeclampsia during pregnancy or within seven days after delivery after ruling out epilepsy or any other convulsive disorder were treated as eclamptic women. Group II: Women having BP> 140/90 mmhg and significant proteinuria (>300mg/24hrs) and or edema are treated as preeclampsia. Group III: Normotensive women having pregnancy >20weeks were considered as control group. Total sample size was 66 pregnant women. 22 patients are taken from each group. The platelet indices e.g. MPV, PDW and also PLCR are in consistent relationship with PIH. The higher their values, the greater severity of PIH, from preeclampsia to eclampsia. The estimation of platelet count and indices offer early, simple, rapid assessments of the disease for its severity and the risk of complications. Therefore these tests may be considered as screening tests to be routinely performed in antenatal workup of women with PIH.
... The present study is also in agreement with the observations made by Santos et al. 9 and Mondal et al. 10 The MPV values obtained in the study of Mondal et al. 10 were 10.05 ± 0.71 fL, 11.55 ± 0.86 fL, and 12.16 ± 1.05 fL in normal pregnancy, patients with Preeclampsia and eclampsia, respectively. Hence, their conclusion that the MPV is higher in preeclamptic and eclamptic women than normotensive women supports the observations and results of the present study. ...
... The present study is also in agreement with the observations made by Santos et al. 9 and Mondal et al. 10 The MPV values obtained in the study of Mondal et al. 10 were 10.05 ± 0.71 fL, 11.55 ± 0.86 fL, and 12.16 ± 1.05 fL in normal pregnancy, patients with Preeclampsia and eclampsia, respectively. Hence, their conclusion that the MPV is higher in preeclamptic and eclamptic women than normotensive women supports the observations and results of the present study. ...
Background:
Pre-eclampsia (PET) is a potentially devastating multi-systemic disorder resulting in the generation of oxidative stress. Platelet activation causes vasoconstriction and release of inflammatory cytokines, resulting in an intensified inflammatory response, endothelial damage, and coagulopathy which culminate in adverse pregnancy outcomes.
Aim:
To compare the platelet parameters between preeclamptic and normotensive pregnant women and their relationship to adverse outcomes in women with pre-eclampsia.
Materials and methods:
This was a case-control study of platelet indices of 60 pre-eclamptic and 60 normotensive pregnant women recruited at 28 weeks and followed till delivery. A blood sample was collected at entry into the study and just before delivery. The sample was analyzed within 1 h of collection using the Mythic 18 hematological auto-analyzer. Data were analyzed using IBM-SPSS version 22. A P-value of <0.05 was considered statistically significant.
Results:
The mean platelet count, Platelet distribution width (PDW), plateletcrit were statistically significantly different between normotensive and severe preeclamptic participants (p= <0.001). Statistically significant differences were not present in any of the platelet parameters between mild and severe PET. The odds of developing eclampsia was low at higher mean platelet count and plateletcrit levels above 161.36 ± 73.74 × 109/L [p = 0.02, AOR = 0.27, 95% CI (0.08-0.88)] and 0.13 ± 0.05% [p = 0.001, AOR = 0.22, 95% CI (0.08-0.58)] respectively. Eclampsia was strongly associated with P-LCR (platelet-large cell ratio) above 23.15 ± 4.92% [p = 0.004, AOR = 11.00, 95%CI (1.48-89.02)]. Abruptio placentae had low odds at lower levels of mean plateletcrit. Pre-term birth was significantly lower at mean plateletcrit levels above 0.14 ± 0.05%; admission into neonatal intensive care unit was strongly associated with a mean PLC ratio above 22.73 ± 5.91%.
Conclusion:
This study demonstrated significant differences in platelet count, plateletcrit, platelet distribution width, and P-LCR between pre-eclamptic and normotensive women. Increase in P-LCR is a risk factor for eclampsia although the effect size is low.
Objective: Mean platelet volume (MPV) has been explored in several observational studies in the field of preeclampsia and current evidence seem to be conflicting. The purpose of the present meta-analysis is to evaluate the reported MPV differences in patients that develop preeclampsia and to compare them to those of otherwise healthy women.
Design and methods: We searched the international literature using the Medline (1966–2018), Scopus (2004–2018), EMBASE (1947-2018) and Clinicaltrials.gov (2008–2018) databases. Statistical meta-analysis was performed using the RevMan 5.3 software.
Results: The meta-analysis was based on outcomes reported from 50 studies that included 14,614 women. MPV was significantly higher in preeclamptic than healthy pregnant women (7,905 women, MD: 1.04 fl, 95% CI [0.76, 1.32]). The mean difference was less evident among women with mild preeclampsia (6,604 women, MD: 0.65 fl, 95% CI [0.19, 1.11]), compared to the severe ones (6,119 women, MD: 1.28 fl, 95% CI [0.75, 1.80]). The results of the univariate meta-regression analysis showed that region, sample size, time to analysis, anticoagulant, platelet count and NOS score did not affect the outcomes of the meta-analysis.
Conclusions: The findings of our meta-analysis suggest that mean platelet volume represents a promising biomarker for the detection and follow-up of patients that develop preeclampsia. However, given that the available evidence is drawn from case-control studies, future cohorts are needed in this field to accurately determine optimal timing and cut-off values that may be used in the clinical setting.
Objective:
To evaluate the role of platelet indices in preeclampsia and eclampsia.
Methods:
An observational analytical study was conducted in Department of Obstetrics and Gynaecology, Ambedkar Hospital, Pandit Jawaharlal Nehru Memorial Medical College, Raipur. It was performed on 150 women between March 2015 and February 2016; among them, 42 were taken as controls, 36 were preeclampsia and 72 were eclampsia. Their platelet count and platelet indices were done, analyzed and compared.
Result:
In our study, we found that mean platelet count and mean plateletcrit showed a significant decrease while mean MPV and mean PDW showed a significant increase with increasing severity of disease. Also, we observed that 66.7% preeclampsia and 51.4% eclampsia were nonthrombocytopenic. Among these women, a decrease in the values of plateletcrit and an increase in PDW were seen in a significantly higher number of eclampsia patients. So these two platelet indices can become the new marker for an adverse outcome in preeclampsia and eclampsia even in women presenting with normal platelet counts.
Conclusion:
Platelet indices showed a significant variation along with the severity of the disease. Platelet indices, especially PDW and plateletcrit, can be used along with platelet count to evaluate the severity of preeclampsia and eclampsia instead of relying on platelet count alone.
