Prospective Observational Study of Mean Platelet Volume and Other Platelet Indices in Preeclampsia and Effects on Maternal and Perinatal Outcome in a Tertiary Care Referral Centre

Abstract

Background and Objectives: Preeclampsia is an obstetric disorder that affects 6-8% pregnancies worldwide. Thrombocytopenia is the common hematological abnormaliz̄ty seen in Preeclampsia & Eclampsia. The tests like PT, APTT, TT and fibronectin level are more sensitive but are expensive and time consuming. Platelet indices like MPV, PC and PDW are inexpensive and derived from routine blood investigations and widespread availability of tests
Materials and Methods: This is a Prospective comparative study conducted on 120 pregnant women who were meeting inclusion and exclusion criteria.from 20 to 28 weeks of gestation. Out of 120 patients 60 patients with Preeclampsia of different severity were matched with 60 patients of healthy normotensive pregnant women who served as case(n=60) and control(n=60) respectively. At each scheduled antenatal visit subsequently 20-28 weeks (visit 1), 29-32 weeks (visit 2), 33-36 weeks (visit 3), and 37-delivery (visit 4) samples were drawn for platelet indices (MPV, PC, PDW) in EDTA vial and the serial record of these indices was maintained. Effect of deranged platelet indices on foeto-maternal outcome was another aim of the study. Feto-maternal outcome was noted and compiled.
Results: In case group majority were Primigravida 37 patients accounting for 61.7%. All platelet indices were found deranged in the PE group. Platelet count decreased significantly from 2.4 + 0.3 lakhs/cumm on first visit to 1.5 + 0.4 lakhs/cumm before delivery while platelet distribution width (PDW) and mean platelet volume (MPV) increased from 13.2fl to 16.9fl and 9.5 fl to 12.2 fl respectively. MPV increased significantly with increasing PE severity (P ˂0.05), it was significantly higher in cases with poor foetal or maternal outcome.
Conclusion: Our study proves that Platelet indices can play a significant role in earlier identification of PE and signal intervention to prevent future complications. MPV among three indices was found to be more sensitive than others to be linked to feto-maternal outcome.