Role of variation in platelet indices in pregnancy-related pathological complications and the prediction of postpartum hemorrhage: a case-control study

Abstract

Pregnancy-related pathological complications (PPCs) increase the risk of postpartum hemorrhage (PPH), Platelet activation and destruction are expected outcomes of PPCs. This study sought to compare the platelet indices of non-pregnant (NP) child-bearing aged women, healthy pregnant (HP) women, and women with PPCs, and investigate the use of these indices in PPH prediction. This retrospective clinical study included 260 NP child-bearing aged women and 119 pregnant women. Of the 119 pregnant patients, 69 had HPs and 50 suffered from PPCs. Further, 50 patients delivered with PPH. We compared the platelet counts (PCs), mean platelet volumes (MPVs), platelet distribution widths (PDWs), plateletcrits (Pcts), MPV ratios (PC/MPV and Pct/MPV), alpha angles (angles), and maximum amplitudes (MAs) of the patients using Sysmex XN10 hematology analyzer and TEG 5000 Hemostasis analyzer system, respectively. With the exception of PDW, there were significant differences in the platelet parameters of the NP, HP, and PPC patients (P<0.05). The intergroup comparison results showed that the NP patients differed significantly from the HP and PPC patients in terms of age, MA, PC, Pct, and Pct/MPV (P<0.0125). Further, the HP and PPC patients differed significantly in terms of Pct, MPV, PC/MPV, and Pct/MPV (P<0.0125). Additionally, the univariate analysis showed that in the PPC patients, low MPV values were strongly related to PPH [odds ratio (OR) =0.012, P=0.003; OR =0.331, P=0.047]. Women with PPCs had significantly lower PC, Pct, PC/MPV and Pct/MPV values, but significantly higher MA and MPV values. PPHs were strongly related to PPC and low MPV values. A timely accurate diagnosis and evaluating MPV values may be useful in the prediction of PPH.