Platelets Count and Indices as possible predictors for pre-eclampsia in Sudanese Women in Khartoum State Maternity Hospitals

Abstract

Pre-eclampsia is one of pregnancy complications that is characterized by hypertension and proteinuria after the 20th week of gestation. The exact etiology of pre-eclampsia is unknown, but it is a common complication of pregnancy that is associated with high maternal morbidity and mortality. This is an analytical case control study carried out among pregnant women with pre-eclampsia (cases) and normal pregnant women (control) at Omdurman Maternity Hospital, Ibrahim Malik Hospital and Academy Charity Teaching Hospital from April to July 2015. The aim of the study was to determine the level of platelets count and platelets indices among Sudanese pregnant women with pre-eclampsia compared with the level among normotensive pregnant women and to identify whether there is any correlation between severity of pre-eclampsia and platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Also To calculate lymphocyte to platelet and red cells to platelet ratios and correlate it with degree of preeclampsia and to find out whether there is any association between gravidity, education, and family history of pre-eclampsia with the development of pre-eclampsia. In this study 120 pregnant women were informed about the study and agreed for participation, 60 of them worked as cases (pregnant women with pre-eclampsia) and the other 60 worked as controls (disease-free pregnant women), Control pregnant women were matched to cases in age group. A short questionnaire was used to identify age, residence, education, occupation, gravida, parity, gestational age, history of hypertension, history of diabetes mellitus, family history of Pre-eclampsia, other chronic or infectious diseases, blood pressure, and proteinuria. Blood samples (2.5 ml) were collected from the participants in EDTA anticoagulant container. All samples were tested using hematology analyzer (Sysmex KX-21N model- Japan). Data were analyzed using Statistical Package for Social Science software (SPSS), and P. value was considered statistically significant at 0.05. Significant differences were found between the two studied groups (cases and control) with regard to platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and platelets large cell ratio (P-LCR) ( P. value 0.00) and between severe and mild cases (P. value 0.02, 0.005,0.008, 0.005), respectively. The mean level of red blood cells to platelets ratio (RPR) was found to be significantly high among pregnant women with severe pre-eclampsia (P. value 0.002), whereas, the difference between the means levels of platelet to lymphocyte ratio (PLR) of mild and severe type of pre-eclampsia was found to be insignificant (P. value= 0.122). This study suggested that, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), platelets large cell ratio (P-LCR), and red blood cells to platelets ratio (RPR) can serve as early monitoring markers for the severity of pre-eclampsia (P. value 0.02, 0.005, 0.008, 0.005, 0.002, respectively). It also revealed that primigravida and family history of pre-eclampsia were considered as one of the main risk factors for developing or experiencing pre-eclampsia (OR: 1.9, 17.7, respectively). Furthermore, educational level and family history of pre-eclampsia were found to be associated with the developing pre-eclampsia (P. value= 0.001 and 0.000, respectively).