PLATELET INDICES IN PREECLAMPSIA AND NORMOTENSIVE PREGNANCY IN A TERTIARY CARE CENTER

Abstract

Among the major health problems causing morbidity and mortality in a mother, preeclampsia is one among the leading cause1. Worldwide, 10% of the pregnant women are identified with hypertensive disorders of pregnancy. Preeclampsia, eclampsia, gestational hypertension and chronic hypertension are included in the hypertensive disorders of pregnancy. One tenth of the maternal mortality are associated with increased blood pressure recordings in pregnancy in Asia and Africa. PE is a disorder affecting multiple systems in pregnancy and is characterized by the presence of high blood pressure and proteinuria after completed 20 th week of pregnancy 2 . Early-onset preeclampsia is defined as disease developing before 34 weeks’ gestation, whereas late-onset preeclampsia is defined as disease developing at or after 34 weeks’ gestation 3 . The presence of preeclampsia complicate around 3–8% of pregnancies 2 .The prevalence of preeclampsia in the developing countries ranges between 1.8 to 16.7% 4 .In India, incidence of preeclampsia is reported to be 8-10%. The prevalence of hypertensive disorders of pregnancy in India was found to be as 7.8% with preeclampsia in 5.4%. Around 16-18% of maternal perinatal deaths and up to 40% of foetal and neonatal deaths are caused due to preeclampsia 3 . The preeclamptic patients are observed with higher level of mean platelet volume (MPV) and platelet distribution width (PDW) as compared to normal pregnancy women 12 .The pathophysiology of the disease involve placental vascular under-perfusion, maternal endothelial damage and elevated vascular xvi permeability13.The defective placental trophoblastic invasion causes the injured endothelium to activate the platelets 14 .Coagulation system gets contracted by the activated platelets. It leads to an increased consumption and bone marrow production of megakaryocyte15 . As a result young PLTs are released by the bone marrow which are larger in size resulting in increased MPV, PDW and PLCR , which are platelet indices 16,17 . AIMS AND OBJECTIVES: 1. To document platelet indices in normotensive pregnancy. 2. To document platelet indices in pre eclampsia. 3. To assess the platelet indices in pre eclampsia and normotensive pregnancy Materials and Methods: Study site: The current study is conducted in the department of Obstetrics and gynaecology at RLJH hospital Kolar. Study population:All the pregnant women with normal BP readings and preeclampsia patients delivered at RLJH hospital were considered as study population. Study design: The current study was a cross sectional study Sample size: There are 2 groups considered , xvii Group B –66 singleton normotensive pregnant women after completed 20 week of gestation. Group A- 66 singleton pregnancy with hypertension developed after 20 weeks of pregnancy. Conclusion This study concluded that there is decrease in platelet count and increase in the platelet indices like MPV, PDW, P-LCR in preeclampsia women as compared to normal pregnant women. Adverse neonatal outcomes like intrauterine growth restriction and foetal distress are also found to be more in women with preeclampsia. Particularly in developing countries like India , the platelet indices can be used as effective biomarkers which are both easy and economical to obtain. Platelet