Platelet Count and Platelet Distribution Width: Potential Predictive Biomarkers for Preeclampsia and Eclampsia

Abstract

Introduction: Hypertensive disorders of pregnancy are one of the most common obstetric pathologies, affecting approximately 8-10% of all pregnancies worldwide, including entities like preeclampsia and eclampsia. Preeclampsia increases the risk of maternal morbidity and mortality, foetal mortality, and preterm birth. Early identification of preeclampsia and eclampsia helps in the effective management and favourable outcome of pregnancy. Aim: To determine the relationship between platelet parameters, namely Platelet Count (PC) and Platelet Distribution Width (PDW), with preeclampsia and eclampsia. Materials and Methods: A hospital-based analytical crosssectional study was conducted in the Department of Pathology in collaboration with the Department of Obstetrics and Gynaecology, including 100 pregnant women attending the antenatal clinic in Jorhat Medical College and Hospital, Jorhat, Assam, India, for a duration of one year (from June 2021 to July 2022). Pregnant women meeting the inclusion criteria were selected and divided into two broad groups: a comparison group comprising normotensive pregnant women (n=50) and a study group (n=50), which further included subgroups of preeclamptic women (n=35) and eclamptic women (n=15). A 5 mL venous blood sample was drawn and collected in an Ethylenediaminetetracetic acid (EDTA) vial from both groups and analysed using a six-part fully automated haematology cell counter (SYSMEX XN-550) for PC and PDW. Changes in PC and PDW were compared between the two groups using a student t-test with GraphPad software. A p-value of <0.05 was considered statistically significant. Results: The mean PC in preeclampsia was 185.714±69.56×103 / μL, while in eclampsia, it was 147.53±56.927×103 /μL. The mean value of PDW in preeclampsia was 18.4314±4.184 fL, while in eclampsia, it was 14.86±3.854 fL. A decrease in PC was found to be statistically significant in eclampsia (p-value <0.001). PDW was statistically significantly different among normotensive, preeclamptic, and eclamptic participants (p-value <0.001). The increase in PDW was higher in eclamptic patients compared to preeclamptic patients. Conclusion: Hence, the estimation of PC and PDW can be used as a screening test for the early identification of preeclampsia and eclampsia. Platelet parameters may act as an indicator of preeclampsia and eclampsia. The prognosis of preeclampsia and eclampsia in pregnant women can also be assessed, making them effective prognostic markers as PDW correlates with disease severity. Moreover, these indices are cost-effective and easily available.