Abstract
Background and Objectives: In this study, we investigated the changes of platelet count and other platelet indices, such as mean platelet volume (MPV), in cases with severe early intrauterine fetal growth restriction (IUGR). Materials and Methods: We retrospectively analyzed all pregnancies diagnosed with severe early onset IUGR, that were followed up in our hospital between 2010 and 2015 (before implementation of screening and prophylaxis with aspirin). Pregnancies which resulted in birth of a newborn with a birthweight less than 5th percentile for gestational age, that required delivery for fetal or maternal indication before 32 weeks, were selected for the IUGR group. The IUGR cases were divided into two groups according to preeclampsia (PE) association. All cases with a complete blood count (CBC) performed within 7 days prior to delivery were included in the study, as the IUGR group. The control group included normal singleton pregnancies, delivered at term, with birthweight above 10th centile and a CBC taken at 30–32 weeks. Results: There was a significant difference in platelet count and MPV values between the IUGR group and control. Cases with IUGR presented lower platelet count and higher MPV values; there was no significant difference of these parameters when PE was associated with IUGR. Conclusions: Our results suggest that in cases of severe early IUGR, even in the absence of clinically diagnosed PE, there may be maternal endothelial damage and platelet consumption in the systemic and uteroplacental circulation. Platelet count and MPV values are simple and widely available laboratory tests that might be used as indicator of placental insufficiency; however, prospective data are required to establish the mechanistic link and to which extent these parameters are good predictors of severity or adverse perinatal outcomes.
Highlights
Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity and complicates 3–7% of pregnancies
We retrospectively analyzed all women that were followed up at Filantropia Hospital, a tertiary obstetric care center in Bucharest, between 2010 and 2015, and selected the cases with early onset severe intrauterine fetal growth restriction (IUGR), defined as estimated fetal weight below the 5th percentile for gestational age, that required delivery before 32 weeks of gestation for either abnormal Doppler changes, according to the TRUFFLE study [6], or for maternal indication. All cases with these criteria and with a complete blood count (CBC) performed within 7 days prior to delivery were included in the study as IUGR group
There is a lack of data or contradictory results regarding a possible association between platelet changes and IUGR, many studies focused on the changes of platelets indices in patients with preeclampsia
Summary
Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity and complicates 3–7% of pregnancies. We investigated the changes of platelet count and other platelet indices, such as mean platelet volume (MPV), in cases with severe early intrauterine fetal growth restriction (IUGR). Results: There was a significant difference in platelet count and MPV values between the IUGR group and control. Conclusions: Our results suggest that in cases of severe early IUGR, even in the absence of clinically diagnosed PE, there may be maternal endothelial damage and platelet consumption in the systemic and uteroplacental circulation. Platelet count and MPV values are simple and widely available laboratory tests that might be used as indicator of placental insufficiency; prospective data are required to establish the mechanistic link and to which extent these parameters are good predictors of severity or adverse perinatal outcomes
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