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Lin Z, Fang B, Zhu D, Wang D, Lin X, Yu X, Wang F, Yang C. The Relationship between the Level of Coagulative Function Hypertensive Disorder Complicating Pregnancy. Niger J Clin Pract 2024; 27:599-603. [PMID: 38842709 DOI: 10.4103/njcp.njcp_645_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/27/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND AND AIM Preeclampsia, a pregnancy complication associated with significant maternal and perinatal mortality and morbidity, has been found to be closely linked to dysfunction in the blood coagulation-fibrinolysis system. However, the relationship between hematologic data and severity and onset time of preeclampsia remains unclear. This study aimed to identify specific hematologic parameters in both preeclamptic and normotensive pregnant women and determine their potential significance in the pathogenesis of preeclampsia. MATERIALS AND METHODS A total of 112 patients with gestational hypertension disease were divided into two groups: early-onset preeclampsia (32 cases) and late-onset preeclampsia (80 cases). A control group of 82 normotensive pregnant women matched for age and parity was also selected. Blood samples were collected from all participants to test for specific hematologic parameters. RESULTS Mild and severe preeclampsia were associated with lower hemoglobin level (P = 0.01 and P = 0.03, respectively), higher mean platelet volume (P = 0.01 and P = 0.01, respectively) and fibrinogen (P = 0.01 and P = 0.01, respectively), and shorter prothrombin time (P = 0.02 and P = 0.01, respectively) and activated partial thromboplastin time (P = 0.01 and P = 0.02, respectively). CONCLUSION These findings have provided evidence on the hematologic coagulative actors in the pathogenesis and severity of preeclampsia.
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Affiliation(s)
- Z Lin
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - B Fang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - D Zhu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - D Wang
- Department of Respiratory, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - X Lin
- Department of Osteology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - X Yu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - F Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - C Yang
- Department of Nutrition, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Sekiguchi M, Muromoto J, Ogawa K, Ozawa K, Miyasaka N, Sago H. Longitudinal hematological change in uncomplicated twin pregnancies: The white blood cell count decreases through pregnancy after the first trimester. Taiwan J Obstet Gynecol 2024; 63:381-386. [PMID: 38802202 DOI: 10.1016/j.tjog.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Longitudinal hematological changes throughout twin pregnancies have not been reported. This study aimed to reveal longitudinal changes in hematological indices in twin pregnancies. MATERIALS AND METHODS We conducted a retrospective chart review of hematological changes in uncomplicated twin pregnancies delivered at ≥37 weeks of gestation between 2010 and 2013 and randomly selected uncomplicated singletons during the same period. A complete blood count and hemogram were performed as blood examinations in the first trimester (9-13 weeks), late second trimester (22-27 weeks), mid-third trimester (33-35 weeks, only in twin pregnancies), and late third trimester (36-38 weeks). We evaluated inter-trimester differences in hematological indices and compared the values between twin and singleton pregnancies in each trimester. RESULTS The final analysis group included 60 twin pregnancies and 63 singleton pregnancies. The white blood cell (WBC) count in twin pregnancies decreased throughout the pregnancy after the first trimester and became significantly lower than that in singletons in the late third trimester. The WBC count showed only a slight decrease in the third trimester in singleton pregnancies, whereas it showed a marked decrease throughout the pregnancy in twin pregnancies. The marked decrease in the total WBC count in twin pregnancies is mainly due to a decrease in neutrophils. The red blood cell count and hemoglobin and hematocrit values in twin pregnancies showed more marked decreases in the second trimester than in singletons. No decrease was observed after the second trimester of pregnancy. The platelet count decreased in the third trimester of twin pregnancies. CONCLUSION We clarified the longitudinal hematological changes in twin pregnancies that showed augmentation of or differed from those of singleton pregnancies. It should be specifically mentioned that the WBC count markedly decreased through pregnancy after the first trimester, which is a characteristic change in twin pregnancies.
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Affiliation(s)
- Masaki Sekiguchi
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan; Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Jin Muromoto
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kohei Ogawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Katsusuke Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naoyuki Miyasaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Dionisio LM, Favero GM. Platelet indices and angiogenesis markers in hypertensive disorders of pregnancy. Int J Lab Hematol 2024; 46:259-265. [PMID: 37953406 DOI: 10.1111/ijlh.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Activated platelets exert a key role in the pathogenesis of preeclampsia (PE). There is evidence of distinctive patterns of platelet indices in PE in comparison to healthy pregnancies, therefore these indices can be potential tools for PE detection, risk stratification, and management. Considering the vascular aspects of its pathophysiology, PE is characterized by the increased levels of soluble FMS-like tyrosine kinase-1 (sFlt-1) an antiangiogenic factor, and reduced placental growth factor (PlGF), a proangiogenic factor. This study aimed to assess the platelet indices in hypertensive disorders of pregnancy (HDP) and its correlation with angiogenesis-related biomarkers. METHODS The groups for the study were: control (n = 114); gestational hypertension; (n = 112), and PE (n = 42). The platelet indices included were platelet counts (PLT-I and PLT-F), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet large cell ratio (P-LCR), and immature platelet fraction (IPF# and IPF%). Serum levels of sFlt-1 and PlGF were assessed. RESULTS PLT-I, PLT-F, and PCT% were lower in PE, while MPV, PDW, P-LCR, IPF%, and IPF# were increased. The parameter MPV presented the best performance for the discrimination of PE. There was a moderate positive correlation between sFlt-1 levels and MPV, PDW, and P-LCR. CONCLUSION Platelet indices can be potentially applied as additional tools for the diagnosis and management of HDP. Activated platelets may act as an extra source of sFlt-1 in PE.
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Affiliation(s)
- Laura Mattana Dionisio
- Department of Clinical Analysis and Toxicology, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
- Department of General Biology, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Giovani Marino Favero
- Department of Clinical Analysis and Toxicology, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
- Department of General Biology, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
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Ye D, Li S, Ding Y, Ma Z, He R. Clinical value of mean platelet volume in predicting and diagnosing pre-eclampsia: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1251304. [PMID: 37868773 PMCID: PMC10587588 DOI: 10.3389/fcvm.2023.1251304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Background Pre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean platelet volume (MPV), a functional marker of platelets, as a potentially useful predictor for the diagnosis of PE. Methods PubMed, China Biomedical Literature Database, Chinese National Knowledge Infrastructure, Embase, Wanfang, VIP, and Cochrane Library databases were searched to gather diagnostic trials evaluating the diagnosis of PE using MPV, from their inception to 13 March 2023. We also searched Google Scholar and Baidu. Results A total of 22 studies from 20 articles were found. The pooled diagnostic accuracy of the MPV for PE recognition was as follows: sensitivity (SEN) 0.676 [95% confidence interval (CI) (0.658-0.694)], specificity (SPE) 0.710 [95% CI (0.703-0.717)], and diagnostic odds ratio (DOR) 7.012 [95% CI (4.226-11.636)], and the SROC-AUC and Q* indices were 0.7889 and 0.7262, respectively. The pooled SEN, SPE, and DOR of the diagnostic accuracy of MPV for PE before 16 weeks of gestation were 0.707 [95% CI (0.670-0.743)], 0.639 [95% CI (0.611-0.667)], and 4.026 [95% CI (2.727-5.943)], and the SROC-AUC and Q* indices were 0.7278 and 0.6753, respectively. For the interval of truncation values between 9 and 10 fl, the SROC-AUC and Q* indices for MPV were 0.8856 and 0.8162, respectively. Conclusions Available evidence suggests that MPV has a moderate predictive and diagnostic value for PE, particularly in diagnosing after 20 weeks of gestation. The diagnostic accuracy is higher when the MPV cut-off falls between 9 and 10 fl. The sensitivity of MPV alone in diagnosing PE is not high, and the combination of other markers for predictive diagnosis may better differentiate PE. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425154, identifier: CRD42023425154.
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Affiliation(s)
- Dan Ye
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Shuwen Li
- Department of Obstetrics, Lanzhou University Second Hospital, Lanzhou, China
| | - Yi Ding
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Zhenqin Ma
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Rongxia He
- Department of Obstetrics, Lanzhou University Second Hospital, Lanzhou, China
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Woldeamanuel GG, Tlaye KG, Wu L, Poon LC, Wang CC. Platelet count in preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023; 5:100979. [PMID: 37098392 DOI: 10.1016/j.ajogmf.2023.100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a systematic review and meta-analysis to evaluate the association in pooled samples and in detail. DATA SOURCES A systematic literature search was performed using Medline, Embase, ScienceDirect, Web of Science, Cochrane Library, NICHD-DASH, LILACS, and Scopus from inception to April 22, 2022. STUDY ELIGIBILITY CRITERIA Observational studies comparing platelet count between women with preeclampsia and normotensive pregnant women were included. METHODS The mean differences with 95% confidence interval in platelet count were calculated. Heterogeneity was assessed using I2 statistics. Sensitivity and subgroup analyses were conducted. Statistical analysis was performed using RevMan 5.3 and ProMeta 3 software. RESULTS A total of 56 studies comprising 4892 preeclamptic and 9947 normotensive pregnant women were included. Meta-analysis showed that platelet count was significantly lower in women with preeclampsia than in normotensive controls (overall: mean difference, -32.83; 95% confidence interval, -40.13 to -25.52; P<.00001; I2=92%; mild preeclampsia: mean difference, -18.65; 95% confidence interval, -27.17 to -10.14; P<.00001; I2=84%; severe preeclampsia: mean difference, -42.61; 95% confidence interval, -57.53 to -27.68; P<.00001; I2=94%). Significantly lower platelet count was also observed in the second trimester (mean difference, -28.84; 95% confidence interval, -44.59 to -13.08; P=.0003; I2=93%), third trimester (mean difference, -40.67; 95% confidence interval, -52.14 to -29.20; P<.00001; I2=92%), and before the diagnosis of preeclampsia (mean difference, -18.81; 95% confidence interval, -29.98 to -7.64; P=.009; I2=87%), but not in the first trimester (mean difference, -15.14; 95% confidence interval, -37.71 to 7.43; P=.19; I2=71%). Overall, the pooled sensitivity and specificity of platelet count were 0.71 and 0.77, respectively. The area under the curve was 0.80. CONCLUSION This meta-analysis confirmed that platelet count was significantly lower in preeclamptic women, irrespective of severity and presence or absence of associated complications, even before the onset of preeclampsia and in the second trimester of pregnancy. Our findings suggest that platelet count may be a potential marker to identify and predict preeclampsia.
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Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kenean Getaneh Tlaye
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Ling Wu
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Liona C Poon
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR.
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[Hematologic and nutritional states are associated with the development of preeclampsia in a Mexican population]. NUTR HOSP 2023; 40:78-87. [PMID: 36602139 DOI: 10.20960/nh.04110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Introduction: nutrient and trace element deficiency are risk factors for the development of preeclampsia; these nutrients induce changes in the hematologic state, which can be used to prevent complications during pregnancy. Objective: this research will analyze the nutritional and hematological status during the 3 trimesters of gestation in pregnant women with preeclampsia to evaluate its association with gestational alterations. Method: a cross-sectional, descriptive, and analytic study was conducted on 78 pregnant women who attended a prenatal control clinic, 11 of whom were diagnosed with preeclampsia. The hematological parameters were determined through hematometry. To get the nutritional intake profile of the pregnant women, a frequency of food consumption questionnaire was used. Results: the normotensive group´s arterial pressure (PA) was significantly lower than that of pregnant women with preeclampsia. The hematological profile changed during pregnancy, and platelet value was much higher in preeclamptic women. The nutritional status of pregnant women in the third trimester consumed more macronutrients and micronutrients than in the first and second trimesters, and this pattern was observed in pregnant women with preeclampsia. When compared to pregnant women with preeclampsia, normotensive women received more minerals and vitamins. Conclusion: hematological values are modified during each trimester of gestation, and pregnant women with preeclampsia had high platelet values compared to normotensive women. Our data show a greater intake of minerals and vitamins in normotensive pregnant women as compared to those who developed preeclampsia; therefore, it is recommended that pregnant women be provided with nutritional guidance in order to prevent pregnant complications.
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Wu J, Zhang J, Yang J, Zheng TQ, Chen YM. Association between platelet indices and risk of preeclampsia in pregnant women. J OBSTET GYNAECOL 2022; 42:2764-2770. [PMID: 35959779 DOI: 10.1080/01443615.2022.2109136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We aimed to examine the association between the platelet indices and the risk of preeclampsia (PE) at different gestational weeks (GW) to explore the feasibility of early prediction of PE with these indices. About 7314 normotensive pregnant women and 396 PE patients were included and platelet indices, including platelet count (PC), plateletcrit (PCT), platelet distribution width (PDW), mean platelet volume (MPV) at different gestational weeks (1-12, 13-28, 29-32, 33-36 and 37-41 GW) were compared in two statistical methods. Patients with PE tended to have higher means of PC, PCT, PDW and MPV than normal pregnant women at early stage of pregnancy. The odds of PE were significantly increased with the increase of PC, PCT, PDW and MPV both at 13-28 GW and 29-32 GW, which indicated that increased values of PC, PCT, PDW and MPV at 13-32 GW were associated with greater subsequent risk of preeclampsia. Increased PC, PCT, PDW and MPV may have potential to predict preeclampsia before the disease onset.Impact StatementWhat is already known on this subject? Previous studies indicated that preeclampsia patients may have decreased platelet count (PC), plateletcrit (PCT) and increased platelet distribution width (PDW) and mean platelet volume (MPV). Increased PDW and MPV or decreased PC/MPV may have predictive values for PE.What do the results of this study add? The discrepancy with previous studies lay in the increased values of PC and PCT in PE patients at early stage of pregnancy. The study indicated that increased PC, PCT, PDW and MPV may have potential to predict preeclampsia far ahead of the disease onset. The results may reflect the abnormal turnover of platelets in PE patients.What are the implications of these findings for clinical practice and/or further research? These findings may help to guide early interventions before progress to overt preeclampsia by predicting onset of preeclampsia via easily available platelet indices in early weeks of gestation, which is especially valuable in areas lacking medical resources. The inconsistency with previous studies can facilitate researchers to further explore the coagulation mechanism beneath preeclampsia and pay more attention to the dynamic changes of platelet indices and other coagulation indices during pregnancy.
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Affiliation(s)
- Jinjuan Wu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jinying Yang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Thomas Qintian Zheng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China.,Department of Obstetrics and Gynecology, Valleywise Health/District Medical Group, 2601 E. Roosevelt Road, Phoenix, AZ, USA.,Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Yu-Ming Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
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Walle M, Gelaw Y, Getu F, Asrie F, Getaneh Z. Preeclampsia has an association with both platelet count and mean platelet volume: A systematic review and meta-analysis. PLoS One 2022; 17:e0274398. [PMID: 36103491 PMCID: PMC9473393 DOI: 10.1371/journal.pone.0274398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
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 I2 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 × 109/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.
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Affiliation(s)
- Muluken Walle
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Getu
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Walle M, Asrie F, Gelaw Y, Getaneh Z. The role of platelet parameters for the diagnosis of preeclampsia among pregnant women attending at the University of Gondar Comprehensive Specialized Hospital antenatal care unit, Gondar, Ethiopia. J Clin Lab Anal 2022; 36:e24305. [PMID: 35202493 PMCID: PMC8993625 DOI: 10.1002/jcla.24305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/22/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Preeclampsia (PE) is a pregnancy‐related illness characterized by high blood pressure (BP) and proteinuria after the 20th gestational week (GW). Platelet (PLT) parameter changes are the common hematological abnormalities observed in PE patients. The main aim of this study was to assess the role of PLT parameters for PE diagnosis among pregnant women. Methods A comparative cross‐sectional study was conducted at the University of Gondar Specialized Hospital. A total of 126 pregnant women (63 normotensive [NT] and 63 PE) were recruited using a convenient sampling method. Three milliliter blood was collected from each participant, and PLT parameters were determined using Sysmex XS‐500i analyzer. An independent t‐test supplemented with receiver‐operating characteristics (ROC) were used for comparisons and diagnostic value of PLT parameters between the study groups. Results Platelet count (PC) was significantly lower in the PE group compared to that in the NT group, whereas mean platelet volume (MPV), platelet large cell ratio (P‐LCR), and platelet distribution width (PDW) were significantly higher in PE. MPV had the largest area under the curve (AUC) [0.91: 95% CI; 0.85–0.96] followed by PC [0.79: 95% CI; 0.72–0.87]. MPV can differentiate PE patients from NT pregnant women at cut‐off value ≥12.10 fl (84.1% sensitivity and 87.3% specificity) while PC can indicate PE at a cut‐off value ≤176.5 × 109/L (65.1% sensitivity and 87.3% specificity). Conclusion A decreased PC and an increased MPV, P‐LCR, and PDW can be used as a simple, cost‐effective, quick, and reliable method of PE screening. Of them, MPV is the best indicator of PE.
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Affiliation(s)
- Muluken Walle
- Department of Medical laboratory science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Umezuluike BS, Anikwe CC, Nnachi OC, Iwe BC, Ifemelumma CC, Dimejesi IB. Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study. Heliyon 2021; 7:e08484. [PMID: 34917795 PMCID: PMC8645439 DOI: 10.1016/j.heliyon.2021.e08484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/19/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Benjamin S. Umezuluike
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
| | - Chidebe C. Anikwe
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
| | - Oluomachi C. Nnachi
- Department of Haematology and Blood Transfusion, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
| | - Bobbie C.A. Iwe
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
| | - Chinedu C. Ifemelumma
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
| | - Ikechukwu B.O. Dimejesi
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria
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Bawore SG, Adissu W, Niguse B, Larebo YM, Ermolo NA, Gedefaw L. A pattern of platelet indices as a potential marker for prediction of pre-eclampsia among pregnant women attending a Tertiary Hospital, Ethiopia: A case-control study. PLoS One 2021; 16:e0259543. [PMID: 34752500 PMCID: PMC8577759 DOI: 10.1371/journal.pone.0259543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Preeclampsia is the most serious health risk during pregnancy for both the mother and the fetus. Even though platelet parameters are among the proposed biomarkers for the prediction of preeclampsia, the use of its indices in the diagnosis of preeclampsia is not increasing in Ethiopia. There is little information on platelet patterns in preeclampsia and normal pregnancy. The purpose of this study was to determine the pattern of platelet indices in women with preeclampsia in our study setting. METHODS A case-control study was conducted among 180 pregnant women who attended anti-natal follow-ups from January 1 to April 3, 2019. An Ethylene Diamine Tetra Acetic Acid anti-coagulated venous blood was collected and analyzed using a hematology analyzer (MINDRAY®-BC-300Plus, Shenzhen China). The SPSS software version 26 was used to run the Mann Whitney U test, Kruskal-Wallis H test, and Kolmogorov-Smirnov normality test, Post-hock test augmented with Benforeni, receiver operating characteristics curve, and Spear Man rank-order correlation. A P-value of <0.05 was considered statistically significant. RESULTS A total of 180 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In contrast, the mean platelet volume and platelet distribution widths were significantly increased with the severity of preeclampsia (P<0.001). Platelet distribution width (rho = 0.731, p<0.001) and mean platelet volume (rho = 0.674, p<0.001) had statistically significant positive relationships with mean arterial pressure. The best metric for predicting preeclampsia was platelet distribution width (AUC = 0.986; 95%CI; 0.970, 1). CONCLUSIONS Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.
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Affiliation(s)
- Solomon Gebre Bawore
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Berhanu Niguse
- Wachemo University Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital, Hadiya Zone, Southern Nation Nationality People Region, Hosaena, Ethiopia
| | - Yilma Markos Larebo
- Department of Epidemiology, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Nigussie Abebe Ermolo
- Nigussie Abebe Ermolo, Department of Health Service Management, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Lealem Gedefaw
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Forstner D, Guettler J, Gauster M. Changes in Maternal Platelet Physiology during Gestation and Their Interaction with Trophoblasts. Int J Mol Sci 2021; 22:ijms221910732. [PMID: 34639070 PMCID: PMC8509324 DOI: 10.3390/ijms221910732] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 01/06/2023] Open
Abstract
Upon activation, maternal platelets provide a source of proinflammatory mediators in the intervillous space of the placenta. Therefore, platelet-derived factors may interfere with different trophoblast subtypes of the developing human placenta and might cause altered hormone secretion and placental dysfunction later on in pregnancy. Increased platelet activation, and the subsequent occurrence of placental fibrinoid deposition, are linked to placenta pathologies such as preeclampsia. The composition and release of platelet-derived factors change over gestation and provide a potential source of predicting biomarkers for the developing fetus and the mother. This review indicates possible mechanisms of platelet-trophoblast interactions and discusses the effect of increased platelet activation on placenta development.
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Alasztics B, Kovács ÁF, Molvarec A, Koller Á, Szabó G, Fekete N, Buzás EI, Pállinger É, Rigó J. Platelet-derived extracellular vesicles may contribute to the hypercoagulable state in preeclampsia. J Reprod Immunol 2021; 148:103380. [PMID: 34534879 DOI: 10.1016/j.jri.2021.103380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022]
Abstract
It has previously been shown that preeclampsia is associated with disturbed hemostasis and that extracellular vesicles (EVs) play important role in the regulation of hemostatic homeostasis. Thus, we hypothesized that the altered procoagulant characteristics of circulating platelet-derived EVs may contribute to the disturbed hemostasis in preeclampsia. Using multicolor flow cytometry, we have analyzed both tissue factor expressing procoagulant EVs and platelet-derived EV subpopulations derived from resting and activated thrombocytes by examining them in plasma samples of preeclamptic patients and pregnancy-matched healthy individuals. Compared to pregnancy-matched healthy individuals in preeclamptic patients a significantly (p < 0.05) higher ratio of Annexin-V positive activated platelets and a higher number of CD142+ tissue factor bearing procoagulant EVs were found, whereas the absolute amount of circulating CD41a+ platelet-derived EVs and CD62P+/CD41a+ EVs produced by activated thrombocytes was significantly lower in the plasma of preeclamptic women. In the plasma samples, there was no significant difference in the amount of CD63+ platelet-derived EVs. We propose that increased platelet activation and tissue factor expression of platelet derived extracellular vesicles may contribute to the hypercoagulable state observed in preeclampsia.
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Affiliation(s)
- Bálint Alasztics
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
| | - Árpád Ferenc Kovács
- Department of Genetics, Cell- and Immunobiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; 2(nd) Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Molvarec
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ákos Koller
- Department of Translational Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary; Department of Physiology, New York Medical College, Valhalla, NY, 10595, USA
| | - Gábor Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Nóra Fekete
- Department of Genetics, Cell- and Immunobiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Edit Irén Buzás
- Department of Genetics, Cell- and Immunobiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Éva Pállinger
- Department of Genetics, Cell- and Immunobiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - János Rigó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Department of Clinical Studies in Obstetrics and Gynecology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
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Mayama M, Morikawa M, Yamada T, Umazume T, Noshiro K, Nakagawa K, Saito Y, Chiba K, Kawaguchi S, Watari H. Mild thrombocytopenia indicating maternal organ damage in pre-eclampsia: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:91. [PMID: 33509105 PMCID: PMC7845117 DOI: 10.1186/s12884-021-03564-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Currently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of < 100 × 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of < 150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count < 150 × 109/L and ≥ 100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. Methods A total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥ 150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥ 100 × 109/L; and severe thrombocytopenia, < 100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.
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Affiliation(s)
- Michinori Mayama
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan.
| | - Mamoru Morikawa
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Takashi Yamada
- Department of Obstetrics and Gynecology, Japan Community Health Care Organization Hokkaido Hospital, Toyohira-ku, Nakanoshima 1-8, Sapporo, Hokkaido, Japan
| | - Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Kiwamu Noshiro
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Kinuko Nakagawa
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Yoshihiro Saito
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Kentaro Chiba
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Satoshi Kawaguchi
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, 060-8638, Sapporo, Hokkaido, Japan
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Mishra S, Jaiswar S, Saad S, Tripathi S, Singh N, Deo S, Agarwal M, Mishra N. Platelet indices as a predictive marker in neonatal sepsis and respiratory distress in preterm prelabor rupture of membranes. Int J Hematol 2020; 113:199-206. [PMID: 33108614 DOI: 10.1007/s12185-020-03025-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
Preterm Prelabor rupture of membranes (PPROM) accompanies 2-3% of all pregnancies and 1/3rd of all preterm deliveries leading to intraamniotic infection, postpartum infections, sepsis along with perinatal morbidity and mortality worldwide. Early diagnosis and treatment can prevent the complications of PPROM and improve mother and child health. The platelet indices (platelet count, Mean platelet volume, Plateletcrit and Immature platelet fraction) could be a useful predictive parameters in PPROM, as platelets are acute phase reactants and there parameters may vary with inflammation and increased platelet consumption/production. In the present study, Mean Platelet volume (MPV) levels showed significant increase in cases as compared to controls (10.47 ± 1.92 fl Vs 8.84 ± 1.30 fl; P < 0.004). Plateletcrit (PCT) levels were also significantly increased in cases with respect to controls (0.22 ± 0.10% Vs 0.18 ± 0.05%; P = 0.004). Immature platelet fraction (IPF) is significantly increased in cases than in control subjects (8.73 ± 6.67% Vs 4.43 ± 1.75%; P < 0.001). Also, Mean Platelet volume (MPV) levels were found to be significantly higher in subjects whose neonate had developed sepsis(11.39 ± 1.69 fl Vs 8.91 ± 1.31 fl; P < 0.001) and respiratory distress (10.62 ± 2.09 fl Vs 9.26 ± 1.56 fl; P = 0.003). Similarly, PCT was significantly higher in groups with positive neonatal sepsis (0.32 ± 0.74% Vs 0.19 ± 0.65%; P = 0.010) and with respiratory distress (0.24 ± 0.78% Vs 0.18 ± 0.59%; P < 0.001). Levels of IPF were also increased in positive neonatal sepsis group (10.11 ± 6.27% Vs 5.06 ± 4.07%; P < 0.001) and respiratory distress group (9.11 ± 6.38% Vs 5.54 ± 4.43%; P = 0.009). The findings suggest that maternal platelet parameters (MPV, PCT and IPF) can be utilized as evidence of early predictors of development of neonatal sepsis and respiratory distress and may be considered as a predictive markers for adverse neonatal outcome.
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Affiliation(s)
- Sanjay Mishra
- Postgraduate Department of Pathology, King George's Medical University, Lucknow, India.
| | - Shyampyari Jaiswar
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
| | - Sumaiya Saad
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
| | - Shalini Tripathi
- Department of Pediatrics, King George's Medical University, Lucknow, India
| | - Nisha Singh
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
| | - Sujata Deo
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
| | - Monika Agarwal
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
| | - Neetu Mishra
- Postgraduate Department of Pathology, King George's Medical University, Lucknow, India
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Can Platelet Count and Mean Platelet Volume be Used as Markers of Postdural Puncture Headache in Obstetric Patients? Pain Res Manag 2020; 2020:6015309. [PMID: 32831983 PMCID: PMC7428937 DOI: 10.1155/2020/6015309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
Objective In this study, considering the importance of platelet function in inflammatory processes, we explored whether there are relationships of platelet indices with postdural puncture headache (PDPH) and pain developing after use of spinal needles and whether patient characteristics contribute to the development of PDPH. Methods This prospective, observational study included 76 patients (Group 1) with PDPH and 93 patients (Group 2) without PDPH. The postoperative hemoglobin, hematocrit, platelet count (PC), and mean platelet volume (MPV) values were recorded, along with age, blood type, Rh factor, gravida, parity, and gestational age. In addition, the time of the onset of pain was recorded in patients who complained of a postspinal headache. Results Hemoglobin and hematocrit values in Group 1 were significantly lower than in Group 2 (both, p=0.024). The PC of Group 1 was significantly higher than that of Group 2 (p < 0.001), whereas the MPV was significantly lower (p < 0.001). The area under the curve (AUC) values were significant for hemoglobin, hematocrit, PC, and MPV (p=0.022, p=0.024, p < 0.001, and p < 0.001, resp.). For MPV, the AUC value was 0.293, sensitivity was 1%, and specificity was 99%. The highest likelihood ratio (LR+) value was 1.22 at a cut-off value of 13.3 fL. For the PC, the AUC value was 0.666, the sensitivity was 9%, and the specificity was 99%, while the highest LR + value was 8.56 at a cut-off value of 352 × 109/L. There was no significant relationship between the parameters examined and the onset of pain. Conclusion In this study, the PC was higher and MPV was lower in obstetric patients with PDPH compared with the control group. However, we also found that these two values cannot be used as markers of PDPH.
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Alterations of Several Serum Parameters Are Associated with Preeclampsia and May Be Potential Markers for the Assessment of PE Severity. DISEASE MARKERS 2020; 2020:7815214. [PMID: 32025276 PMCID: PMC6983284 DOI: 10.1155/2020/7815214] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 12/29/2022]
Abstract
The precise pathophysiological mechanisms of preeclampsia (PE) and preventative strategies remain unknown. Laboratory markers which can help in identifying PE patients from pregnant women and assessing the severity of PE during pregnancy are worthy to be explored. In this study, a retrospective case-control study was designed to assess whether the serum levels of albumin (ALB), total protein (TP), prealbumin (PA), alkaline phosphatase (ALP), lactic dehydrogenase (LDH), D-dimer, fibrinogen (Fbg), platelet (PLT) count, mean platelet volume (MPV), and platelet distribution width (PDW) can help in assessing PE and evaluate its severity. 256 pregnant women were enrolled and classified into 3 groups: mild preeclampsia (mPE, n = 85), severe preeclampsia (sPE, n = 78), and healthy normotensive controls (control, n = 93). Our result showed that the serum levels of ALP, LDH, and D-dimer were significantly higher in mild or severe PE patients compared with the healthy controls (66 (52.5-76.5) vs. 168 (141.5-201.25) vs. 182.5 (120-191.5), 152 (139.75-166.25) vs. 183.5 (163.25-307) vs. 282 (215.25-306), 1.05 (0.65-1.57) vs. 3.05 (2.25-4.08) vs. 5.65 (2.29-7.71)), while ALB, TP, and PA are lower (38 (37-42) vs. 31.5 (25.5-34.5) vs. 28.5 (24-33), 65 (63-68.25) vs. 56.5 (52-61) vs. 51.5 (49-58), 219.14 ± 68.25 vs. 167.88 ± 52.21 vs. 143.22 ± 50.46). On the other hand, compared with the mPE group, the sPE group showed significantly lower PLT count but higher level of LDH, D-dimer, and Fbg. No significant differences in MPV or PDW were found between any of the two groups. In conclusion, the above markers except for the MPV and PDW may be correlated with PE severity in this patient cohort, indicating possible values of these potential biomarkers in auxiliary diagnosis and severity assessment of PE.
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Tesfay F, Negash M, Alemu J, Yahya M, Teklu G, Yibrah M, Asfaw T, Tsegaye A. Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia. PLoS One 2019; 14:e0225536. [PMID: 31751422 PMCID: PMC6874061 DOI: 10.1371/journal.pone.0225536] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/06/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Platelet parameters alterations are one of the most commonly identified hematological changes in preeclampsia (PE). However, their functions as a tool for prediction and prognosis of PE have not been extensively studied in developing countries. The aim of this study was to compare platelet count (PC), and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) between preeclamptic and normotensive (NT) pregnant women and assess their role in diagnosis and prediction of PE development. METHODS A cross sectional comparative study was conducted at Ayder comprehensive specialized hospital (ACSH) and Mekelle general hospital (MGH) from January to March 2017. Platelet parameters of mild preeclamptic (mPE) (n = 35), severe preeclamptic (sPE) (n = 44) and NT pregnant women (n = 140) were analyzed using SYSMEX-XT 4000i automated hematology analyzer. One-way ANOVA supplemented with post-hoc test, receiver operating characteristics (ROC) curve and pearson correlation test statistical analyses were performed. P < 0.05 was considered significant. RESULT Pregnant women with sPE had lower PC as compared with that of mPE and NT women (p<0.05). All platelet indices showed significant increment with severity of PE. PC was negatively correlated with platelet indices. There was a positive correlation among platelet indices. ROC analysis revealed that MPV had the largest area under the ROC curve (0.85; 95%CI (0.79, 0.89)) with cutoff value >9.45fl, sensitivity of 83.5%, specificity of 86.4%, positive predictive value of 77.6% and negative predictive value of 90.3%. CONCLUSION MPV and PC were identified as good candidates for sPE diagnosis. Because evaluation of platelet parameters is rapid, reliable and economical, they can be utilized as an alternative biomarker for prediction and prognosis of PE.
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Affiliation(s)
- Feven Tesfay
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mikias Negash
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jemal Alemu
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammedtahir Yahya
- Department of Gynecology and obstetrics, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Gebre Teklu
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Meseret Yibrah
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tsegay Asfaw
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
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Reddy SG, Rajendra Prasad CSB. Significance of platelet indices as severity marker in nonthrombocytopenic preeclampsia cases. J Lab Physicians 2019; 11:186-191. [PMID: 31579247 PMCID: PMC6771321 DOI: 10.4103/jlp.jlp_161_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Preeclampsia is often asymptomatic, and hence, its detection depends on signs or investigations. The platelet (PLT) parameters, in cases of preeclampsia with normal PLT count, are seldom analyzed. Hence, this study was undertaken to study the PLT parameters in nonthrombocytopenic preeclampsia cases. AIM The aim was to evaluate the use of PLT indices as severity markers in nonthrombocytopenic preeclampsia cases. SUBJECTS AND METHODS This prospective study was done on 120 cases of severe preeclampsia, 115 cases of preeclampsia without severe features, and 203 normal pregnant women admitted in the obstetrics wards during the study period of 1 year. The PLT indices obtained by analyzing anticoagulated blood were recorded. STATISTICAL ANALYSIS USED Analysis of variance test was used to see the significance of association. Receiver operating characteristic (ROC) curve and binary regression analysis was used to estimate the cutoff value and examine the predictive value of the PLT parameters in the disease progression of preeclampsia. RESULTS Even in the absence of thrombocytopenia, mean platelet volume (MPV) and PLT distribution width were significantly higher in severe preeclampsia group (P < 0.001) and were also positively correlating with mean arterial pressure (r = 0.38 and 0.20, respectively). ROC curve analysis showed that MPV had the highest area under the curve of 0.78 (95% confidence interval [0.719-0.842]). Cutoff value of >10.95 fl for MPV was found to have significant predictive value for disease progression in preeclampsia. CONCLUSIONS Even in the absence of thrombocytopenia, PLT indices, especially MPV, have a good diagnostic significance in detecting severe preeclampsia. Further studies are required to evaluate their role as biomarkers in preeclampsia.
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Affiliation(s)
- Shilpa Gopal Reddy
- Department of Pathology, MVJ Medical College and Research Hospital, Kolar, Karnataka, India
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Changes of platelet count throughout pregnancy in women with antiphospholipid syndrome. J Reprod Immunol 2019; 136:102612. [PMID: 31542513 DOI: 10.1016/j.jri.2019.102612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/22/2019] [Accepted: 09/09/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Antiphospholipid antibodies (aPL) activate several cell types, such as endothelial cells, monocytes, neutrophils, fibroblasts, trophoblasts and platelets, thus leading to thrombosis and obstetric complications in patients with antiphospholipid syndrome (APS). The aim of the present study was the longitudinal investigation of platelet count in women with APS. Additionally, platelet count in women with APS who developed preeclampsia during pregnancy were compared to women with APS and uncomplicated pregnancy for potential early detection of preeclampsia. MATERIAL AND METHODS This longitudinal study included 65 women with APS, 38 women with preeclampsia and 84 women with normal pregnancies, where platelet count was determined every four weeks, starting in early pregnancy. RESULTS Platelet count was significantly lower in women with APS compared to women who developed preeclampsia and normal pregnancies starting at 12 weeks of gestation. The areas under the curve (AUC) for platelet count were 0.765 at 12 weeks of gestation (95% of CI of 0.634-0.896), 0.747 at 20 weeks (95% of CI of 0.600-0.894), 0.719 at 24 weeks (95% of CI of 0.555-0.882), respectively. The cut off points for platelets were 216 at 12-14 weeks of gestation, 226.5 at 20 weeks of gestation, and 163.5 at 24 weeks of gestation, respectively. DISCUSSION We demonstrated a significant lower platelet count in women with APS throughout gestation. Additionally, platelet count is significantly decreased in women with APS who developed preeclampsia. According to our results, platelet count seems to have a predictive value for the development of preeclampsia in these women.
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Mtali YS, Lyimo MA, Luzzatto L, Massawe SN. Hypertensive disorders of pregnancy are associated with an inflammatory state: evidence from hematological findings and cytokine levels. BMC Pregnancy Childbirth 2019; 19:237. [PMID: 31288789 PMCID: PMC6617701 DOI: 10.1186/s12884-019-2383-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/27/2019] [Indexed: 01/20/2023] Open
Abstract
Background Abnormalities of blood cell counts and of cytokine profiles in women with hypertensive disorders of pregnancy (HDP) have been reported in several studies. Although their cause-effect relationships to HDP are not yet clear, detecting and monitoring these alterations can be of use for prognosis and management of HDP. This study aimed to determine hematological, coagulation and cytokine profiles in hypertensive as compared to normotensive pregnancy and to identify correlations between these profiles. Methods This was a hospital-based comparative cross-sectional study conducted from September 2017 to February 2018. There were two groups: the comparison group consisted of 77 normotensive pregnant women attending the antenatal clinic of Muhimbili National Hospital (MNH); the index group consisted of 76 hypertensive pregnant women admitted to the maternity block of the same hospital. Hematological and cytokine parameters were compared between the hypertensive and the normotensive group. We analyzed the data using Student’s independent t-test when the data were normally distributed; and the Mann–Whitney U-test when the data were not normally distributed. Kruskal Wallis with Dunn’s multiple comparison tests was run for subgroup analysis and correlation studies were done using Spearman ranking. Results Hemoglobin levels were slightly but significantly lower, (P < 0.01) in women with HDP compared to normotensive (N) women; the same was true for platelet counts (P < 0.001). The red cell distribution width (RDW) was slightly but significantly higher in HDP than in N. Neutrophil counts and Interleukin 6 (IL-6) levels were significantly (P < 0.001) higher in HDP than in N; and within HDP IL-6 levels increased with increasing severity of HDP. A novel remarkable finding was that eosinophil counts, normal in N, were lower and lower with increasing severity of HDP, to the point that they were nearly absent in women with eclampsia. Conclusion There are significant changes in hematological, cytokine and coagulation parameters in pregnant women with hypertensive disorders compared to normotensive pregnant women. The picture that emerges is that of an inflammatory state associated with hypertensive disorders of pregnancy.
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Affiliation(s)
- Yohana Silas Mtali
- Department of Hematology and blood transfusion, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
| | - Magdalena Amani Lyimo
- Department of Hematology and blood transfusion, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Lucio Luzzatto
- Department of Hematology and blood transfusion, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Siriel Nanzia Massawe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
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Mayer-Pickel K, Stern C, Eberhard K, Lang U, Obermayer-Pietsch B, Cervar-Zivkovic M. Comparison of mean platelet volume (MPV) and sFlt-1/PlGF ratio as predictive markers for preeclampsia. J Matern Fetal Neonatal Med 2019; 34:1407-1414. [PMID: 31257953 DOI: 10.1080/14767058.2019.1638356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Preeclampsia is characterised by an increased platelet consumption with consecutive reduction of overall platelet count and a consecutive rise in mean platelet volume (MPV). MPV has therefore been suggested as a predictive marker for preeclampsia. We aimed to investigate MPV longitudinally in women with preeclampsia compared to healthy controls during pregnancy for potential early detection of preeclampsia and to compare potential MPV changes against the sFlt-1/PlGF ratio. STUDY DESIGN This longitudinal study included 38 women with preeclampsia and 84 women with normal pregnancies, where MPV and sFlt-1 and PLGF levels were determined every 4 weeks, starting in early pregnancy. RESULTS MPV was significantly higher in women who developed preeclampsia compared to women with normal pregnancies at 12, (p = .029), 24 (p = .011), 28 (p = .037), 32 (p = .002), and 36 weeks of gestation, respectively (p = .015). Further analysis revealed a cut-off point of 10.85 fl (sensitivity 65.6%, specificity 26.2%) for the prediction of preeclampsia. The sFlt-1/PlGF ratio was significantly higher in women who developed preeclampsia compared to women with normal pregnancies at the same time points (p = .001). The cut-off point for predicting preeclampsia was 10.3 (sensitivity 87.5%, specificity 11.9%). ROC curve analysis showed that MPV has a high predictive value for early-onset preeclampsia (p < .05) but not for late-onset preeclampsia. CONCLUSION MPV is significantly elevated even in early pregnancy in women who develop preeclampsia and seems, therefore, a valuable predictor for preeclampsia even at early gestation. However, according to our results, MPV seems reliable in predicting early onset preeclampsia.
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Affiliation(s)
| | - Christina Stern
- Department of Obstetrics, Medical University Graz, Graz, Austria
| | - Katharina Eberhard
- Computational Bioanalytics, Center for Medical Research, Medical University Graz, Graz, Austria
| | - Uwe Lang
- Department of Obstetrics, Medical University Graz, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
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Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematol Transfus Cell Ther 2018; 41:129-133. [PMID: 31084762 PMCID: PMC6517612 DOI: 10.1016/j.htct.2018.08.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/03/2018] [Accepted: 08/13/2018] [Indexed: 11/16/2022] Open
Abstract
Background Preeclampsia is one of the major health problems causing maternal morbidity and mortality, complicating 3–8% of pregnancies. It has been suggested that the alterations in the coagulation and fibrinolysis play a role in the pathogenesis of preeclampsia. The markers of platelet activation include platelet count, platelet distribution width, mean platelet volume and plateletcrit. Study design It was a case-controlled study which included a total of 60 patients (30 cases and 30 controls). Blood samples were collected and the platelet indices – platelet count, plateletcrit, mean platelet volume and platelet distribution width – were evaluated using the Sysmex XN1000 and compared between the two groups. Results The MPV and PDW also showed a significant difference (p > 0.05) between the two groups, with a significant positive correlation with increasing blood pressure (MPV – r = +0.6126, p < 0.05 and PDW – r = +0.6441, p < 0.05). The PC and PCT had lower values in the preeclampsia patients, however the difference between the two groups was not statistically significant. Conclusion The MPV and PDW showed a significant difference between the two groups and increasing values with increasing BP. However, the PC and PCT in our study did not show a significant correlation with preeclampsia. Thus, the platelet indices, mainly the MPV and PDW, which are economical and easily available, can be reliable in the prediction and early diagnosis of preeclampsia, as well as a marker for the severity of preeclampsia.
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Affiliation(s)
- Nitesh Thalor
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Kanika Singh
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India.
| | - Mukta Pujani
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Varsha Chauhan
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Charu Agarwal
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
| | - Rashmi Ahuja
- Employees State Insurance Corporation Medical College, Faridabad, Haryana, India
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Monteith C, Egan K, O'Connor H, Maguire P, Kevane B, Szklanna PB, Cooley S, Malone F, Áinle FN. Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study. J Perinat Med 2018; 46:1010-1015. [PMID: 29267172 DOI: 10.1515/jpm-2017-0188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/07/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To characterise Mean platelet volume (MPV) in patients with early onset preeclampsia (EOPE) and unaffected controls from time of first antenatal visit until the postpartum. MATERIALS AND METHODS Retrospective secondary analysis of an observational study in an Irish tertiary referral centre with 9000 deliveries annually. The MPV of 27 women with EOPE was compared to 19 unaffected controls. The inclusion criteria for the disease state was the development of EOPE defined by the National Institute for Health and Care Excellence (NICE) guideline, as new onset hypertension presenting after 20 weeks and prior to 34 weeks with significant proteinuria. Between October 2013 and July 2015 we recruited 27 women with EOPE and 19 pregnant controls. Statistical analysis was performed using paired T-test of Mann-Whitney test where appropriate and a P-value <0.05 was deemed significant. RESULTS At time of diagnosis and late in the third trimester MPV was significantly increased to 9.0 (±0.3) fL in cases of EOPE in comparison to 8.5 (±0.6) fL in normotensive controls (P<0.05). There was no significant difference during the first trimester or postpartum when comparing the MPV in EOPE to controls. CONCLUSION Despite an increased MPV at time of diagnosis of EOPE this study did not demonstrate a potential use for increased MPV as a first trimester screening tool.
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Affiliation(s)
- Cathy Monteith
- Clinical Lecturer and Tutor, Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Karl Egan
- University College Dublin (UCD) Conway Institute, School of Medicine and Medical Science, UCD, Dublin 4, Ireland
| | - Hugh O'Connor
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Ireland
| | - Patricia Maguire
- University College Dublin (UCD) Conway Institute, School of Medicine and Medical Science, UCD, Dublin 4, Ireland
| | - Barry Kevane
- University College Dublin (UCD) Conway Institute, School of Medicine and Medical Science, UCD, Dublin 4, Ireland
| | - Paulina B Szklanna
- University College Dublin (UCD) Conway Institute, School of Medicine and Medical Science, UCD, Dublin 4, Ireland
| | - Sharon Cooley
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Ireland
| | - Fergal Malone
- Clinical Lecturer and Tutor, Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Ireland
| | - Fionnuala Ní Áinle
- University College Dublin (UCD) Conway Institute, School of Medicine and Medical Science, UCD, Dublin 4, Ireland.,Department of Haematology, Rotunda Hospital, Parnell Street, Dublin 1, Ireland
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Bellos I, Fitrou G, Pergialiotis V, Papantoniou N, Daskalakis G. Mean platelet volume values in preeclampsia: A systematic review and meta-analysis. Pregnancy Hypertens 2018; 13:174-180. [DOI: 10.1016/j.preghy.2018.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/23/2018] [Indexed: 12/29/2022]
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Abdel Razik M, Mostafa A, Taha S, Salah A. Combined Doppler ultrasound and platelet indices for prediction of preeclampsia in high-risk pregnancies. J Matern Fetal Neonatal Med 2018; 32:4128-4132. [PMID: 29804487 DOI: 10.1080/14767058.2018.1481953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objectives: To evaluate Doppler ultrasound and platelet indices for the prediction of preeclampsia (PE).Design: Prospective observational study.Methods: The study included 270 normal pregnancy primigravida <20 years at 20-24-week gestation. Doppler ultrasound was done to detect uterine artery diastolic notch and to measure the pulsation index (PI) and the resistance index (RI). The platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (Plcr) was measured by automated blood picture.Outcome: Validity of combined tests in prediction of PE.Results: Patients who developed PE had significant higher percentage of diastolic notch, higher mean PI, RI, and significant increase of MPV and PDW than normotensive women (p < .001). Patients with abnormal Doppler and abnormal platelet indices had significant higher incidence of severe PE (p < .001).Conclusion: Abnormal platelet indices combined with abnormal Doppler is a predictor of severity rather than the rate of development of PE.
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Affiliation(s)
- Mohamed Abdel Razik
- Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Benha, Egypt
| | - Ahmed Mostafa
- Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Benha, Egypt
| | - Sara Taha
- Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Benha, Egypt
| | - Ahmed Salah
- Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Benha, Egypt
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Kim MA, Han GH, Kwon JY, Kim YH. Clinical significance of platelet-to-lymphocyte ratio in women with preeclampsia. Am J Reprod Immunol 2018; 80:e12973. [DOI: 10.1111/aji.12973] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Min-A Kim
- Department of Obstetrics and Gynecology; Gangnam Severance Hospital; Institute of Women's Life Medical Science; Yonsei University College of Medicine; Seoul Korea
| | - Gwan Hee Han
- Department of Obstetrics and Gynecology; Gangnam Severance Hospital; Institute of Women's Life Medical Science; Yonsei University College of Medicine; Seoul Korea
| | - Ja-Young Kwon
- Department of Obstetrics and Gynecology; Severance Hospital; Institute of Women's Life Medical Science; Yonsei University College of Medicine; Seoul Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology; Severance Hospital; Institute of Women's Life Medical Science; Yonsei University College of Medicine; Seoul Korea
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Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med 2017; 32:1412-1419. [PMID: 29179639 DOI: 10.1080/14767058.2017.1410701] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Preeclampsia (PE) is a severe pregnancy complication with significant maternal and neonatal morbi-mortality resulting in high health care costs. Prevention, mainly based on the administration of acetylsalicylic acid, is only possible if timely identification of high-risk patients can be realized in an easy, nonexpensive, and widely available method. This paper explores the clinical usability of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) in discriminating between women that will and those that will not develop PE. STUDY DESIGN Demographic data and laboratory results were retrospectively collected and compared in 2050 pregnant women (164 PE and 1886 controls) between 1 January 2014 and 31 January 2016. RESULTS In the PE group, gravidity, parity, gestational age, and birth weight were significantly lower compared to the control group. Before the 20th pregnancy week, MPV was significantly elevated in the PE group compared to the controls (p = .006), hence analysis revealed an optimal cut-off point of 8.15 (sensitivity 66.7%, specificity 56.3%) for predicting PE. At the end of pregnancy, NLR and MPV appeared to be higher and PLR lower in the PE group compared to the controls, which strengthens the current knowledge on the pathogenesis of PE. CONCLUSIONS MPV is significantly elevated in the first half of pregnancy in women who later develop PE and might therefore be implemented in combination with other parameters in a PE prediction model.
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Affiliation(s)
- Dominique Mannaerts
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium.,b Anatomy and Research Centre, Research Group ASTARC, Antwerp Surgical Training, University of Antwerp , Antwerp , Belgium
| | - Suzanne Heyvaert
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium
| | - Chania De Cordt
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium
| | - Claartje Macken
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium
| | - Charlotte Loos
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium
| | - Yves Jacquemyn
- a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium.,b Anatomy and Research Centre, Research Group ASTARC, Antwerp Surgical Training, University of Antwerp , Antwerp , Belgium
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29
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Camara-Lemarroy CR, Escobedo-Zúñiga N, Villarreal-Garza E, García-Valadez E, Góngora-Rivera F, Villarreal-Velázquez HJ. Posterior reversible leukoencephalopathy syndrome (PRES) associated with severe eclampsia: Clinical and biochemical features. Pregnancy Hypertens 2017; 7:44-49. [DOI: 10.1016/j.preghy.2017.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/24/2016] [Accepted: 01/12/2017] [Indexed: 01/21/2023]
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AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag 2016; 12:477-480. [PMID: 27920548 PMCID: PMC5123587 DOI: 10.2147/vhrm.s120944] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although the exact pathophysiology of preeclampsia is not completely understood, the utility of different platelets indices can be utilized to predict preeclampsia. OBJECTIVE To compare platelet indices, namely platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and PC to MPV ratio in women with preeclampsia compared with healthy controls. SETTING Qassim Hospital, Kingdom of Saudi Arabia. DESIGN A case-control study. Sixty preeclamptic women were the cases and an equal number of healthy pregnant women were the controls. RESULTS There was no significant difference in age, parity, and body mass index between the study groups. Sixteen and 44 of the cases were severe and mild preeclampsia, respectively. There was no significant difference in PDW and MPV between the preeclamptic and control women. Both PC and PC to MPV ratios were significantly lower in the women with preeclampsia compared with the controls. There was no significant difference in the PC, PDW, MPV, and PC to MPV ratio when women with mild and severe preeclampsia were compared. Using receiver operating characteristic (ROC) curves, the PC cutoff was 248.0×103/µL for diagnosis of pre-eclampsia (P=0.019; the area under the ROC curve was 62.4%). Binary regression suggests that women with PC <248.010×103/µL were at higher risk of preeclampsia (odds ratio =2.2, 95% confidence interval =1.08-4.6, P=0.03). The PC/MPV cutoff was 31.2 for diagnosis of preeclampsia (P=0.035, the area under the ROC curve was 62.2%). CONCLUSION PC <248.010×103/µL and PC to MPV ratio 31.2 are valid predictors of preeclampsia.
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Affiliation(s)
- Muneera A AlSheeha
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Rafi S Alaboudi
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Mohammad A Alghasham
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
| | - Javed Iqbal
- Department of Obstetrics and Gynecology, Maternity and Children’s Hospital, Qassim, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynaecology, College of Medicine, Qassim University, Buriadah
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Gutierrez-Aguirre CH, García-Lozano JA, Treviño-Montemayor OR, Iglesias-Benavides JL, Cantú-Rodríguez OG, González-Llano O, Gómez-De León A, Salazar-Riojas R, Mancias-Guerra C, Jaime-Pérez JC, Guzman-López A, Gómez-Almaguer D. Comparative analysis of iron status and other hematological parameters in preeclampsia. ACTA ACUST UNITED AC 2016; 22:36-40. [PMID: 27558940 DOI: 10.1080/10245332.2016.1220120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare serum ferritin (SF) concentrations and other hematological parameters between patients with preeclampsia (PE) and normal pregnant women of the same gestational period who received supplemental iron during pregnancy. METHODS Prospective, comparative, observational pilot study that included 31 women with PE and 30 healthy pregnant women, at 20 weeks' of gestation. Ferritin, iron and complete blood cell count were compared between groups. RESULTS In comparison with controls, preeclamptic patients had a higher weight, body mass index, and arterial pressure. Serum ferritin and serum iron were higher in patients with PE (median: 36.5 μg/l vs. 20.9 μg/l and 103.9 μg/dl vs. 90.8 μg/dl) with a significant difference (P = 0.019 and P = 0.345). SF values >40 μg/l correlated with PE (r = 0.281; P = 0.032). A platelet count less than 100 × 109/l was higher in the PE group than in the control group (13% vs. 3%, P = 0.354). CONCLUSION Higher SF levels, despite being within normal range, were associated with PE. The incidence of thrombocytopenia was higher in preeclamptic women, however, the remaining hematological parameters were similar in both groups.
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Affiliation(s)
- César Homero Gutierrez-Aguirre
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - José Alberto García-Lozano
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Oscar Rubén Treviño-Montemayor
- b Obstetrics Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - José Luis Iglesias-Benavides
- b Obstetrics Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Olga Graciela Cantú-Rodríguez
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Oscar González-Llano
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Andrés Gómez-De León
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Rosario Salazar-Riojas
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Consuelo Mancias-Guerra
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - José Carlos Jaime-Pérez
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - Abel Guzman-López
- b Obstetrics Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
| | - David Gómez-Almaguer
- a Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León , Madero y Gonzalitos Sn, Colonia Mitras Centro, Monterrey , N.L. C.P. 64460 , Mexico
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Özdemirci Ş, Başer E, Kasapoğlu T, Karahanoğlu E, Kahyaoglu I, Yalvaç S, Tapısız Ö. Predictivity of mean platelet volume in severe preeclamptic women. Hypertens Pregnancy 2016; 35:474-482. [DOI: 10.1080/10641955.2016.1185113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Association of HIV and highly active antiretroviral therapy with clinical and biochemical indices among women with pre-eclampsia. Int J Gynaecol Obstet 2016; 134:304-8. [PMID: 27350229 DOI: 10.1016/j.ijgo.2016.03.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 02/23/2016] [Accepted: 05/27/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether clinical and biochemical features associated with pre-eclampsia are significantly altered among women with HIV infection taking highly active antiretroviral therapy (HAART). METHODS A prospective observational cohort study was conducted between July 2013 and September 2014 at Prince Mshiyeni Memorial Hospital, Durban, South Africa. Women with and without pre-eclampsia and HIV infection were enrolled at booking and followed up until delivery. Specific demographic data, clinical features, laboratory indices, and complications were analyzed. RESULTS Of 193 participants, 98 had pre-eclampsia (45 [45.9%] with HIV infection). There were no significant differences in clinical features and laboratory indices among the study groups except for γ-glutamyl transferase levels, which were significantly higher among women with pre-eclampsia and HIV infection (26.9±40.9U/L) than among those with pre-eclampsia but no HIV infection (17.1±14.0U/L; P=0.001). Perinatal and maternal complications were similar, and there were no maternal deaths. CONCLUSION Clinical features, laboratory indices, and complications among women with pre-eclampsia and HIV infection taking HAART were similar to those among women with pre-eclampsia without HIV infection. Current guidelines remain appropriate; however, frequent hepatic function tests should be conducted.
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Ureyen I, Ozyuncu O, Sahin-Uysal N, Kara O, Basaran D, Turgal M, Deren O. Relationship of maternal mean platelet volume with fetal Doppler parameters and neonatal complications in pregnancies with and without intrauterine growth restriction. J Matern Fetal Neonatal Med 2016; 30:471-474. [DOI: 10.1080/14767058.2016.1175423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Isin Ureyen
- Department of Gynecology and Obstetrics, Antalya Training and Research Hospital, Antalya, Turkey,
| | - Ozgur Ozyuncu
- Department of Gynecology and Obstetrics, Hacettepe University Medical School, Ankara, Turkey,
| | - Nihal Sahin-Uysal
- Department of Gynecology and Obstetrics, Başkent University Medical School, Ankara, Turkey,
| | - Ozgur Kara
- Department of Gynecology and Obstetrics, Zekai Tahir Burak Women’s Health Teaching and Research Hospital, Ankara, Turkey, and
| | - Derman Basaran
- Department of Gynecology and Obstetrics, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Ankara, Turkey
| | - Mert Turgal
- Department of Gynecology and Obstetrics, Hacettepe University Medical School, Ankara, Turkey,
| | - Ozgur Deren
- Department of Gynecology and Obstetrics, Hacettepe University Medical School, Ankara, Turkey,
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Moraes D, Munhoz TP, Pinheiro da Costa BE, Hentschke MR, Sontag F, Silveira Lucas L, Gadonski G, Antonello IC, Poli-de-Figueiredo CE. Immature platelet fraction in hypertensive pregnancy. Platelets 2015; 27:333-7. [DOI: 10.3109/09537104.2015.1101060] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Daniela Moraes
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Laboratorio de Patologia Clinica –Hospital São Lucas Hospital /Faculdade de Farmácia Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Terezinha Paz Munhoz
- Laboratorio de Patologia Clinica –Hospital São Lucas Hospital /Faculdade de Farmácia Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Bartira E. Pinheiro da Costa
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Marta Ribeiro Hentschke
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Fernando Sontag
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Luiza Silveira Lucas
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Giovani Gadonski
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Ivan Carlos Antonello
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Carlos E. Poli-de-Figueiredo
- Programa de Pos-Graduaçao em Medicina e Ciencias da Saude (Nefrologia), Faculdade de Medicina, Instituto de Pesquisas Biomedicas, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy 2015; 34:434-442. [DOI: 10.3109/10641955.2015.1060244] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nooh AM, Abdeldayem HM. Changes in Platelet Indices during Pregnancy as Potential Markers for Prediction of Preeclampsia Development. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojog.2015.512099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Han L, Liu X, Li H, Zou J, Yang Z, Han J, Huang W, Yu L, Zheng Y, Li L. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One 2014; 9:e114488. [PMID: 25464515 PMCID: PMC4252147 DOI: 10.1371/journal.pone.0114488] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/10/2014] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Preeclampsia (PE) is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE. OBJECTIVES We aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE. METHODS Blood samples from 3 groups of subjects, normal pregnant women (n = 79), mild preeclampsia (mPE) (n = 53) and severe preeclampsia (sPE) (n = 42), were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC) curves of these indices were generated, and the area under the curve (AUC) was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis. RESULTS During late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV) increased compared to early pregnancy (p<0.05). However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD) during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743) and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671) and ideal predictive efficiency. CONCLUSION Normal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE, respectively.
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Affiliation(s)
- Lei Han
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
- Department of Obstetrics and Gynecology, the 306th Hospital of the Chinese People’s Liberation Army, Beijing, P.R.China
| | - Xiaojie Liu
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Hongmei Li
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Jiaqun Zou
- Department of General Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Zhiling Yang
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Jian Han
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Wei Huang
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Lili Yu
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Yingru Zheng
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
| | - Li Li
- Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P.R.China
- * E-mail:
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Wang X, Jiang F, Liang Y, Xu L, Li H, Liu Y, Liu S, Ye Y. Interleukin-1β-31C/T and -511T/C polymorphisms were associated with preeclampsia in Chinese Han population. PLoS One 2014; 9:e106919. [PMID: 25222025 PMCID: PMC4164436 DOI: 10.1371/journal.pone.0106919] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 08/10/2014] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of our study is to investigate the relationship between IL-1β -31C/T (rs1143627) and -511T/C (rs16944) polymorphisms and the preeclampsia (PE), and analyze the Linkage disequilibrium (LD) and haplotype frequency of the two polymorphism loci. Methods Polymorphisms at -31C/T and -511T/C of IL-1β were genotyped with the method of polymerase chain reaction-restriction fragment length polymorphism (PCR- RFLP) in 232 PE and 447 control subjects. Genotype and allele frequencies between case-control groups were compared by chi-square(X2) tests. Two-point LD and haplotype frequency analyses were done with the software Haploview4.2. Results Significant statistical differences were found between PE and control groups regarding genotype and allele frequencies of the two polymorphisms of IL-1β (For IL-1β -31C/T: X2 = 11.478, P = 0.003; For IL-1β-511T/C: X2 = 9.687, P = 0.008). LD analysis revealed that the IL-1β -31C/T SNP was in high LD with the IL-1β-511C/T SNP(D′ = 0.92, r2 = 0.79). Both CT and TC haplotypes showed significant differences between case and control groups. Only the plasma level of Prothrombin Time had a significantly statistical difference among TT, CT and CC groups of the preeclamptic two polymorphisms of IL-1β-31C/T and -511T/C (for IL-1β-31C/T, F = 1.644, P = 0.01; F = 1.587, P = 0.016). Conclusion Our results revealed IL-1β was associated with the PE in Chinese Han population. The CT haplotype may increase the risk of PE, while haplotype TC could be considered as a protective haplotype of PE.
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Affiliation(s)
- Xuefeng Wang
- Prenatal diagnosis center, the Affiliated Hospital of Qingdao University, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Disease, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fengli Jiang
- Department of clinical laboratory diagnosis, Medical College, Qingdao University, Qingdao, China
| | - Yu Liang
- Department of Interventional radiology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lina Xu
- Department of Respiratory Medicine, Heze Medical College, Heze, China
| | - Hongbo Li
- Department of Interventional radiology, The Songshan Hospital of Medical College, Qingdao University, Qingdao, China
| | - Yali Liu
- Internal medicine, The Qingdao Fuwai Cardiovascular Hospital, Qingdao, Qingdao, China
| | - Shiguo Liu
- Prenatal diagnosis center, the Affiliated Hospital of Qingdao University, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Disease, the Affiliated Hospital of Qingdao University, Qingdao, China
- * E-mail: (SL); (YY)
| | - Yuanhua Ye
- Prenatal diagnosis center, the Affiliated Hospital of Qingdao University, Qingdao, China
- * E-mail: (SL); (YY)
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Iyidir OT, Degertekin CK, Yilmaz BA, Toruner FB, Akturk M, Arslan M. Elevated mean platelet volume is associated with gestational diabetes mellitus. Gynecol Endocrinol 2014; 30:640-3. [PMID: 24898134 DOI: 10.3109/09513590.2014.922946] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Elevated MPV values are associated with larger and more active platelets and perceived as a new independent cardiovascular risk factor. The aim of this study was to determine the MPV in women with gestational diabetes mellitus (GDM) and to determine the correlation of MPV with metabolic parameters in GDM. We retrospectively analyzed 30 women with GDM and 38 body mass index-matched women with healthy pregnancies as controls. MPV and platelet counts were recorded in the third trimester and at postpartum 6-12 months for GDM group and in the third trimester for control group. Third-trimester MPV was significantly higher in GDM group compared to control group (8.8 ± 1.0 versus 8.1 ± 0.7 fl, p = 0.002). In women with GDM, there was a significant decrease in MPV in the postpartum period (8.8 ± 1.0 versus 8.1 ± 0.8 fl, p < 0.001). Fasting plasma glucose levels and glucose area under the curve were positively correlated with third trimester MPV (r = 0.346, p = 0.007 and r = 0.346, p = 0.02, respectively). Our results indicate that MPV is increased in GDM. Monitoring MPV, which is widely available in clinical practice, may potentially identify women who will develop gestational diabetes during pregnancy.
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Affiliation(s)
- Ozlem Turhan Iyidir
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University , Beşevler, Ankara , Turkey
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Incebiyik A, Seker A, Vural M, Gul Hilali N, Camuzcuoglu A, Camuzcuoglu H. May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease? Wien Klin Wochenschr 2014; 126:422-6. [PMID: 24958650 DOI: 10.1007/s00508-014-0560-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/02/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID). METHODS Overall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted. RESULTS MPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = - 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively). CONCLUSION Since the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.
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Affiliation(s)
- Adnan Incebiyik
- Faculty of Medicine, Department of Gynecology and Obstetrics, Harran University, Yenisehir Campus, 63300, Sanlıurfa, Turkey,
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Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2014; 175:107-11. [PMID: 24502873 DOI: 10.1016/j.ejogrb.2013.12.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/14/2013] [Accepted: 12/21/2013] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the platelet distribution width (PDW) and other platelet indices as potential severity markers of preeclampsia (PE). STUDY DESIGN A total of 935 pregnant women who had received continuous prenatal care and had undergone delivery were included. The participants were classified into 3 groups: healthy pregnant women (n=816), pregnant women with mild PE (n=59), and pregnant women with severe PE (n=60). Blood samples were collected during antenatal care or at the time of admission, and the platelet indices were compared among the three groups. RESULTS Among the three groups, the platelet count and plateletcrit decreased as the disease progressed. The mean platelet volume and the PDW, however, increased as the disease progressed. When compared to the levels of other platelet indices, the PDW showed significant elevation in the severe PE group. In the mild and severe PE groups, the PDW was statistically correlated with the mean arterial pressure (MAP) (r=0.231, p<0.05), whereas other platelet indices were not. In the receiver operating characteristics curve analysis, the area under the curve of the PDW to predict severe PE was 0.74. CONCLUSIONS Among platelet indices, the PDW is significantly higher in women with severe PE than in women with mild PE, and is positively correlated with the MAP. Therefore, the PDW can serve as a candidate marker for predicting the severity of PE.
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Affiliation(s)
- Seung Woo Yang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Han Sung Kwon
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - In Sook Sohn
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Han Sung Hwang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.
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