Platelet Count and Platelet Indices as Possible Predictors for Pre-eclampsiain Sudanese Pregnant Women in AldamarLocality Maternity Hospitals

Abstract

Pre-eclampsia is one of pregnency complications that is characterized by hypertension and proteinuria after the 20th week of gestation. The exact etiology of pre-eclampsia is un known, but its a common complication of pregnency that is associated with high maternal morbidity and mortality . This is un analytical case control study carried out among 60 pregnant women with pre eclampsia (cases) matched in age with normal 60 pregnant women (control)at Atbara maternity hospitals , Aldamar maternity hospitals from May to September 2017. The aim of the study was to determine the level of platelets count and platelets indicese among Sudanese pregnant women with pre-eclampsia compared with level among normotensive pregnant women and to identify whether there is any correlation between sevierity 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 platelets ratios and correlated with degree of pre-eclampsia and to find out wether there is any association between gravidity , education , and family history of pre-eclampsia with the development of pre-eclampsia . A short questionnaire was used to identify age ,education , occubation , gravida , parity , gestational age , history of hypertention , history of diabetes mellitus , family history of pre-eclampsia , other chronic or infectious disease , blood pressure and proteinuria . Blood samples (2.5 ml) wre collected from the participents in EDTA anticogulant container . All samples were tested using haematology 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 with regard to platelet count, mean platelet volum (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) (P.value 0.00) and between severe and mild case (p-value 0.02, 0.005, 0.008, 0.005) respectively . The mean level of red blood cells to pletelet ratio (RPR) was found to be significantly high among pregnant women with severe preeclampsia (P value 0.002), wherreas, the difference between the means levels of platelet to lymphocyte ratio (PLR) of mild and severe type of preeclampsia was found to be insignificant (P value = 0.122). This study suggested that, platelet count ,mean platelet volume (MPV), platelet distribution width (PDW) and platelets large cell ratio (P-LCR), and red blood cells to platelet ratio (RPR) can serve as early monitoring markers for the severity of pre-eclampsia (P.value0.02, 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 developing pre-eclampsia (P-value =0.001 and 0.000 respectively).