Platelet Count Estimation Research Articles

Evaluation of artificial intelligence-assisted morphological analysis for platelet count estimation.

This study aims to assess the performance of the platelet count estimation using artificial intelligence technology on the MC-80 digital morphology analyzer. Digital morphology analyzer uses two different computational principles for platelet count estimation: based on PLT/RBC ratio (PLT-M1) and estimate factor (PLT-M2). 977 samples with various platelet counts (low, median, and high) were collected. Out of these, 271 samples were immunoassayed using CD61 and CD41 antibodies. The platelet counts obtained from the hematology analyzer (PLT-I and PLT-O), digital morphology analyzer (PLT-M1 and PLT-M2), and flow cytometry (PLT-IRM) were compared. There was no significant deviation observed before and after verification for both PLT-M1 and PLT-M2 across the analysis range (average bias: -0.845/-0.682, 95% limit of agreement (LOA): -28.675-26.985/-29.420-28.056). When platelet alarms appeared, PLT-M1/PLT-M2 showed the strongest correlation with PLT-IRM than PLT-I with PLT-IRM (r: 0.9814/0.9796 > 0.9601). The correlation between PLT-M1/PLT-M2 and PLT-IRM was strong for samples with interference, such as large platelets or RBC fragments, but relatively weak in small RBCs. The deviation between PLT-M1 and PLT-M2 is related to the number of RBCs. Compared with PLT-I, PLT-M1/PLT-M2 showed higher accuracy for platelet transfusion decisions, especially for samples with low-value PLT. The novel platelet count estimation on the MC-80 digital morphology analyzer provides high accuracy, especially the reviewed result, which can effectively confirm suspicious platelet count.

Comparison of platelet count by automated hematology analyzer and peripheral blood smear in thrombocytopenic patient

Platelet count estimation is one of the common as well as important laboratory investigations to diagnose many diseases like dengue, malaria etc. Different methods for platelet estimations are automated haematology analyzer, peripheral blood smear examination method etc. Most common causes of inaccurate platelet count by automated analyser are the presence of giant platelets, platelet clumps etc. leading to erroneous result like false low platelet count etc. We aimed to compare platelet count estimation by automated haematology analyzer and the peripheral blood smear examination in thrombocytopenic patients. A comparative cross-sectional study was conducted on 100 blood samples of patients which came thrombocytopenic on automated haematology analyzer. Each case was also analyzed by peripheral blood smear examination and compared with its corresponding automated haematology platelet count value. Our study included 63% males and 37% females, with the mean age of 38.8 years. Most of the patients belonged to the age group of 30-40 years (34%). The mean platelet count on automated analyzers was 85.46 ± 38.81 x 103/uL whereas on peripheral smear was 92.13 ± 38.30×103/uL with a significant difference between the two groups (p-value <0.0001).Pseudo-thrombocytopenia was observed in 10% of patients, with giant platelets observed in 29% of the cases on blood smear. In view of false low platelet count by automated analyser, we concluded that manual examination by peripheral blood smear examination should always be considered whose platelet count is low by automation.

Comparison of Platelet Counts Estimated by Peripheral Blood Smear Examination and Automated Haematology Analyzer

Introduction: Platelet count estimation is one of the common as well as important investigations in clinical practice to diagnose many diseases like dengue, malaria, etc. Different methods for platelet estimations are available. These methods are manual counting semi-automated and automated hematology analyzer counting, platelet count estimation by peripheral blood smear (PBS) method, etc. Semi-automated or automated analyzers may produce erroneous results in the presence of particles or light scatter like giant platelets, fragmented red blood cells, and platelet clumps, so alternative methods like PBS examination can be used for validation. Aim: To compare platelet count estimation performed by the automated cell counter method and the PBS examination method. Objective: Peripheral Blood smear examination acts as a good quality control tool to validate the results produced by the automated cell counter. Materials and Methods: The present study was carried out in the Department of Pathology, Akshaya Health Centre, Urban Bangalore. The study included 100 random blood samples collected into ethylenediaminetetraacetic acid (EDTA) vacutainers over 3 months. These were analyzed by both peripheral blood smear and automated cell counter for platelet estimation. The statistical analysis was done for test performances and their comparisons by using the coefficient of variation (CV), linear regression, and mean differences with SPSS software. Results: No significant difference (p = 0.06635) was observed between the manual peripheral blood smear (PBS) method (platelets average per 100x, multiplied by 15000/ µl) of platelet estimation (207.13 ±15.898 x 1000/ µl) and that of automated cell counter platelet value (206.53 ±16.278 x 1000/ µl). A significant positive correlation was observed between the results of both methods (r=0.9995, p < 0.001) when analyzed by the Pearson correlation test. Conclusion: The peripheral blood smear platelet estimation results are comparable with automated analyzer results. Hence, the PBS examination serves as a quality control tool in assessing the results of the automated cell counters.

ESTIMATION AND COMPARISON OF PLATELET COUNT: AUTOMATED ANALYZERVS MANUAL PERIPHERAL SMEAR METHOD

Accurately assessing platelet counts holds paramount importance in the realm of diagnostics and treatment. The adoption of automated methods within the diagnostic landscape is steadily growing, attributed to their multifaceted benefits. Nonetheless, automated analyzers sometimes yield erroneous results, particularly in scenarios involving particles of comparable sizes or instances of light scattering. These encompass fragmented red blood cells (RBCs), microcytic RBCs, and the presence of oversized platelets or platelet clusters. In response, the manual estimation of platelet counts using Leishmans stain validation gains significance. Method: this study encompassed the collection of blood samples from a diverse pool of 100 patients, including both inpatients and outpatients, spanning the period from 1st February 2023 to 31st July 2023. These samples, procured from GMC Doda and its affiliated hospital, were collected in ethylenediaminetetraacetic acid (EDTA) tubes. The manual platelet count was done, followed by a comprehensive comparative analysis with the counts obtained through automated platelet analysis. Results: the outcomes unveiled a nuanced trend, with manual slide-derived results slightly surpassing those generated by automated analyzers. Conclusion: This study concluded a discernible correlation between automated and manual methodologies for platelet count assessment. Nevertheless, in instances marked by exceedingly high or low platelet counts, the manual method holds its ground, ensuring precision by circumventing concerns like platelet clumping or uneven distribution.

Platelet count and platelet indices in patients of pregnancy-induced hypertension at a rural tertiary care hospital in western India

Background: Pregnancy-induced hypertension is a serious complication during pregnancy causing maternal and fetal morbidity and mortality. Pregnancy-induced hypertension associated with thrombocytopenia can help in predicting the severity of the disease. The study aimed to study the platelet count, and platelet indices in Pregnancy induced hypertension patients and compare them with normotensive pregnant women. Materials and methods: This was a case control study, conducted on patients visiting antenatal care (ANC) at a Tertiary care rural hospital in western India. Study population included a total of 82 patients, which were divided into 2 groups with 41 patients in each control (healthy pregnant women) and study groups (pregnant women with PIH). Patients with chronic hypertension and known case of thrombocytopenia were excluded from the study. The blood samples collected were processed on fully automated cell counter for estimation of platelet count and indices. Results: The platelet count in the study group ranged from 186434.1±81086.9 whereas in the control group it was 268659±72206.9, showing that the platelet count was significantly lower in women with Pregnancy induced hypertension than in the control group. The MPV, PDW, systolic BP, diastolic BP was found to be significantly elevated in the study group as compared to the control group. Conclusions: The present study concludes that blood parameter such as platelets count and platelet indices can be considered as an early, economical and easily available parameter for assessment of severity of PIH cases.

Analytical validation of white blood cell differential and platelet assessment on the Sysmex DI-60 digital morphology analyzer.

Digital morphology analyzers are increasingly replacing light microscopy in laboratory hematology practice. This study aimed to perform the analytical validation of the white blood cell (WBC) differential and of reliability of platelet assessment on Sysmex DI-60 (Kobe, Japan). Validation included determination of within-run and between-run precision for WBC differential according to the CLSI EP15-A3 protocol, accuracy and method comparison with light microscopy and with the automated WBC differential from the Sysmex XN-10 hematology analyzer, reliability of platelet clump detection and platelet count estimation. Standard deviations of both pre- and post-classification mostly satisfied manufacturer's criteria for imprecision. Accuracy assessment revealed that only eosinophil count (1.4%) in one peripheral blood smear (PBS) remained outside the declared range (2-10%) after reclassification. Method comparison between DI-60 and light microscopy yielded Spearman's correlation coefficients from 0.37 (basophils) to 0.94 (neutrophils and lymphocytes), minor proportional difference for bands, constant difference for monocytes, both constant and proportional difference for lymphocytes and statistically significant biases for bands, lymphocytes, monocytes and basophils. Diagnostic sensitivity (Se) and specificity (Sp) of DI-60 in detecting immature/pathological cells were 88.7% (95%CI:81.1-94.0) and 83.0% (95%CI:78.7-86.7), respectively, with the area under the curve (AUC) of 0.86 (95%CI:0.82-0.89). Agreement in detection of platelet clumps was 94.8% (kappa coefficient = 0.67, 95%CI:0.53-0.80). Se and Sp of DI-60 to detect platelet clumps were 65.7% (95%CI: 47.8-80.9) and 96.9% (95%CI: 93.9-98.6), respectively, while AUC was 0.81 (95%CI: 0.76-0.86). DI-60 provides reliable WBC differential and platelet assessment. In doubtful cases, the use of light microscopy is still mandatory.

Performance of digital morphology analyzer Medica EasyCell assistant.

The EasyCell assistant (Medica, Bedford, MA, USA) is one of the state-of-the-art digital morphology analyzers. We explored the performance of EasyCell assistant in comparison with manual microscopic review and Pentra DX Nexus (Horiba ABX Diagnostics, Montpellier, France). In a total of 225 samples (100 normal and 125 abnormal samples), white blood cell (WBC) differentials and platelet (PLT) count estimation by EasyCell assistant were compared with the results by manual microscopic review and Pentra DX Nexus. The manual microscopic review was performed according to the Clinical and Laboratory Standards Institute guidelines (H20-A2). WBC differentials between pre-classification by EasyCell assistant and manual counting showed moderate correlations for neutrophils (r=0.58), lymphocytes (r=0.69), and eosinophils (r=0.51) in all samples. After user verification, they showed mostly high to very high correlations for neutrophils (r=0.74), lymphocytes (r=0.78), eosinophils (r=0.88), and other cells (r=0.91). PLT count by EasyCell assistant highly correlated with that by Pentra DX Nexus (r=0.82). The performance of EasyCell assistant for WBC differentials and PLT count seems to be acceptable even in abnormal samples with improvement after user verification. The EasyCell assistant, with its reliable performance on WBC differentials and PLT count, would help optimize the workflow of hematology laboratories with reduced workload of manual microscopic review.

Determination of Platelet Count Estimation Factor on Peripheral Blood Smear Confirmation Using Field Number 22 Microscope

The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p<0.001, R>0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.

Assessment Of Platelet Count And Its Correlation With Severity Of Pre-Eclampsia

Background: Pregnancy induced hypertension (PIH) is the most common medical disorder of pregnancy. The present study wasconducted to assess platelet count and its correlation with severity of pre-eclampsia.Materials & Methods: 108 suspected cases of pregnancy induced hypertension (cases) and group II had controls were assessed forplatelet count.Results: Age group 20-25 years had 14 cases of mild PIH, 24 of moderate and 6 of eclampsia. 26-30 years had 16 cases of mild, 22 ofmoderate and 4 cases of eclampsia and 31-35 years had 6 of mild, 14 of moderate and 2 of eclampsia. Group II had 56, 42 and 10respectively.Conclusion: Estimation of platelet count being simple economical and rapid investigation can be used for early detection of severity ofpreeclampsia. There were more cases of preeclampsia with low platelets.

Estimation of Total Platelet Count From Peripheral Blood Smear Needs a Correction Factor.

BackgroundDespite many advances in platelet counting by cell counters, the problem of falsely low or falsely high total platelet counts (TPC) is common. Many laboratories estimate platelet count on the peripheral smear to cross-check the platelet counts. However, due to the lack of a standard calculation method, discrepant results are obtained from different laboratories leading to confusion among clinicians. We aimed to formulate a standard estimation method for platelet count on peripheral smear.MethodologyIn the first step (in 100 blood samples), we determined the ratio of the TPC obtained by the automated cell counter and the total number of platelets per oil immersion field (filed size: 0.22 mm) of the corresponding blood smears. The mean of the ratios thus obtained was designated as the “multiplication factor” to be used for visual platelet count estimation on the peripheral blood smear. In the subsequent step, validation of the same was done on another 100 samples. TPC on the peripheral smears of these samples was estimated using the above “multiplication factor” and compared with the corresponding TPC obtained on the automated cell counter.ResultsThe “multiplication factor” obtained was 9.4 x 103 in the first set of 100 blood samples. It was used to estimate the platelet value of the second set of 100 blood samples.ConclusionsWe found an excellent agreement between the platelet counts obtained by automated cell counters and the estimation method. We suggest the multiplication factor 9.4 x 103 may be used with correction for microscopic field size to estimate platelet count on peripheral smears. This method is, however, not so reliable for very low platelet counts.

Rotational Thromboelastometry Values After On-Pump Cardiac Surgery - A Retrospective Cohort Study.

Viscoelastic coagulation monitoring is recommended for coagulation management after cardiac surgery, but optimum target values are poorly defined. To determine "to-be-expected" values in rotational thromboelastometry (ROTEM) after heparin reversal, to correlate ROTEM parameters with fibrinogen levels and platelet count, and to estimate the effect of hemoglobin levels on these measurements. We retrospectively analyzed 571 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass from 12/2018 to 08/2020. ROTEM and conventional laboratory measurements were performed 5 to 10 minutes after protamine administration. Clotting times in EXTEM, INTEM, and FIBTEM were significantly prolonged (72.6%, 96.1%, and 31.8% above reference ranges, respectively). Clot firmness parameters in EXTEM and INTEM were relevantly reduced (7.9% to 14.4% and 9.1% to 32.3% below the reference ranges, respectively). There was an excellent linear correlation of FIBTEM amplitude after 10 min (A10) and of maximal clot firmness (MCF) with fibrinogen concentrations (r = .81 and .80). Areas under receiver operating characteristic (AUROC) for identifying hypofibrinogenemia <1.5 g/L were between .80 and .87. No effect of hematocrit was observed. We also found a linear correlation of EXTEM, INTEM, and EXTEM-FIBTEM at both A10 and MCF with platelet counts (.32 to .68). The AUROCs for identifying thrombocytopenia (<100,000/μL) were .79 to .84, and were greater for A10 than for MCF measurements (P=.074, .001, and <.001, respectively). "To-be-expected" ROTEM values after CPB are different from the published reference ranges. ROTEM parameters might allow for reliable estimation of fibrinogen level and platelet count without being influenced by hematocrit.

Diagnostic utility of combined immature and total neutrophil counts along with C-reactive protein in early detection of neonatal sepsis: A cross-sectional study

IntroductionA timely diagnosis is critical for management of Neonatal sepsis. Blood Culture is considered to be the “Gold Standard” for its diagnosis, but it has some limitations. In recent times, highly sensitive and specific inflammatory markers like interleukins, ELISA, counter immune-electrophoresis etc. have been in use for its diagnosis. But these are impractical for developing countries, due to their high cost and requirement of sophisticated equipments. A combination of haematological parameters like total leucocyte count (TLC), immature to total neutrophil ratio (I/T ratio), absolute neutrophil count (ANC), platelet count and C-reactive protein (CRP) estimation provide an early diagnosis of bacteremia. This study was undertaken to evaluate the usefulness of the above mentioned parameters as indicators for early diagnosis of neonatal sepsis. Material and methodsIn the present cross-sectional study, we intent to analyse various hematologic parameters in 160 neonates admitted in the neonatal care unit of a tertiary care hospital in Delhi. We obtained data from the records of blood culture and complete blood counts of neonates from pathology and microbiology departments of the hospital. Out of 160 admitted neonates, 80 were taken as cases and remaining 80 were taken as controls. Medical records were studied to identify infants born at ≥ 34 weeks gestation. CBCs was analysed, blood cultures and CRP were done in department of Microbiology. CBC, CRP and Blood culture was done as per standard protocols and clinical assesment by paediatrician. The statistical analyses were performed using SPSS version 22 for windows. ResultsAmong 80 neonates, who were in early neonatal sepsis, 44 cases (55%) were females, and 36 (45%) were males. The Microbiological profile of 80 septic neonates was analysed. The I/T value, ANC and CRP values were significantly higher in the neonates suffering from sepsis as compared to the control group. Among 80 septic neonates (cases), 30 (37.5%) were having normal ANC while 50 (62.5%) were having increased ANC and 34 (42.5%) were having normal I:T ratio while 46 (57.5%) were having increased I:T ratio. Out of 80 septic neonates (cases), 18 (22.5%) were having normal CRP while 62 (77.5%) were having increased CRP. ConclusionANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in early diagnosis of neonatal sepsis. Although there are many serological markers available, ANC and I/T Ratio serves as a reliable predictor of neonatal sepsis. With a good sensitivity, high specificity and a good negative predictive value these parameters can therefore help in timely and early identification of neonatal sepsis.

English

BACKGROUND Leptospirosis is a worldwide zoonosis. It has a wide range of clinical symptoms ranging from asymptomatic subclinical infection to life-threatening multi-organ dysfunction. Among cardiac manifestations, myocarditis carries utmost importance as it is associated with poor outcomes in terms of morbidity and mortality. Definitive diagnosis of myocarditis by endomyocardial biopsy is difficult to popularize taking economic cost and operational complexity. We chose echocardiography as the imaging diagnosis method of myocarditis rather than cardiovascular magnetic resonance. Diagnosis of myocarditis arrived by using ECG, Echo and Cardiac enzymes. We wanted to estimate the proportion of cardiac involvement by clinical, electrocardiographical, serological and echocardiographical evaluation of patients with leptospirosis admitted in the Medicine department of Govt. Medical College, Thiruvananthapuram and the association of thrombocytopenia among patients with cardiac involvement. METHODS After obtaining institutional approval, 138 leptospirosis patients were enrolled for this study. Patients were interviewed and blood samples were taken for estimation of platelet count and cardiac enzymes. Electrocardiogram and echocardiogram were done, data entered in to excel sheet and analyzed using SPSS. RESULTS In this study out of 138 patients, 11.6 % were having myocarditis as tested by using a combination of cardiac enzymes, ECG, Echo. Twelve percent of patients had echo findings suggestive of myocarditis. Mean platelet counts in patients with myocarditis were below 50000. CONCLUSIONS Cardiac involvement is a serious manifestation occurring in leptospirosis. Besides cardiac MRI, echocardiogram serves as a useful imaging modality in the diagnosis of myocarditis. An electrocardiogram is the most sensitive investigation for the identification of myocarditis. KEY WORDS Leptospirosis, Myocarditis, Echo, ECG, Cardiac Enzymes, Cardiac Involvement.

ANAEMIA AND COMORBIDITIES IN PREGNANT WOMEN ROUTINELY SUPPLEMENTED WITH HAEMATINICS – A CROSS-SECTIONAL STUDY AT THE AWUTU MUNICIPALITY OF GHANA

Background:Anaemia, thrombocytopenia and cardiovascular disease are major public health problems especially in women of childbearing age and have significant effect on pregnancy outcomes. Supplementation with haematinics such as iron, folic acid and/or multivitamins in pregnancy is targeted at reducing the incidence and/ or severity of anaemia, however, these also influence platelet production and occurrence of obesity. Aim: The aim of the study was to assess anaemia, prolonged bleeding tendency and cardiometabolic risk in pregnant women routinely supplemented with haematinics, attending the Kasoa Polyclinic at the Awutu municipality of Ghana. Methods: The study was a cross-sectional design involving consented pregnant women who were routinely administered haematinic supplements such as iron and folic acid, from their first antenatal visit at the hospital. Socio-demographic data was collected using structured questionnaires. In addition, anthropometrics including body mass index (BMI) was obtained. EDTA anticoagulated venous blood samples were obtained for haemoglobin (Hb) and platelet count estimation using automated full blood count analyzer (Sysmex XP 300, USA). Bleeding time assay and stained thin blood films were examined for platelet disorders. The data was analyzed using SPSS version 22.0, and p-value &lt;0.05 was considered statistically significant. Results: The prevalence of anaemia was 53 (51.4%), with 26 (25.2%)-mild and 27 (26.2%)-moderate cases. Likewise, 39 (37.9%) were overweight whereas 40 (38.8%) were obese, whereas 4 (3.9%) had thrombocytopenia. Among the pregnant women utilizing the antenatal care, 98 (95%) confirmed absolute compliance with the haematinic supplementation schedule. Employment and education were significantly associated with compliance. Anaemia prevalence was significantly associated with thrombocytopenia in the pregnant women. Conclusion: The study revealed that although there was high compliance with the haematinic supplementation, the prevalence of anaemia was high and was associated with thrombocytopenia and cardiometabolic risk.

Platelet count estimation on peripheral smear: What should be an acceptable; multiplication factor

Context: Automated cell counters have revolutionised laboratory medicine and are being used worldwide. They give accurate results, can run large number of samples and generate accurate results within a short span of time. Quality check procedures in this equipment ensure accuracy of results. However, for platelet counts, the pathologist is still dependent on confirming the results by manual methods, especially in situations of low platelet count and flagging by the electronic counter. Different laboratories use different methods for manual estimation of platelet counts. Aims: This study was done to compare the platelet counts assessed on peripheral smear examination by different multiplication factors, and to identify the multiplication factor which derives the most accurate platelet count. Settings and Design: This was an observational study. Methods: Peripheral smears prepared from 100 ethylenediaminetetraacetic acid-anticoagulated blood samples were manually examined under oil immersion field (OIF) for platelets. Platelet count was further calculated by multiplying the number of platelets per OIF using multiplication factors of 10,000, 15,000 and 20,000. This was compared with platelet (PLT)/red blood cell (RBC) method and automated platelet counts. Accuracy of various manual methods was evaluated by calculating the per cent difference of the methods with automated analyser counts. Statistical Analysis Used: Descriptive statistics was used for statistical analysis. Results: Manual platelet count estimation on peripheral smear employing multiplication factor of 15,000 was found to have comparable accuracy to analyser counts, followed by the PLT/RBC ratio method. Conclusions: This study confirms that for manual estimation of platelet counts on peripheral smear, a standard multiplication factor of 15,000 on OIF gives the most accurate result, which is closest to counts obtained by automated analysers.

A Study on Maternal and Perinatal Outcome in Gestational Diabetes Mellitus

Background and Aim: Gestational diabetes is initially diagnosed as glucose intolerance in pregnancy which might result in adverse maternal and perinatal outcomes. The present study aimed at different maternal and perinatal outcomes associated with pregnancy complicated by gestational diabetes. Methodology: This cross-sectional study was carried out on 148 women diagnosed with gestational diabetes in the department of Diabetes and Endocrinoogy and Obstetrics/ Gynecology, Hayatabad Medical Complex, Peshawar and Mian Rashid Hussain Shaheed Memorial Hospital Pabbi respectively for duration of six months from April 2021 to September 2021. Maternal and perinatal data were taken from patients' medical records in the hospital database. The data included age, gestational age, parity, mode of delivery, BMI, infant birth weight, antenatal complications and both maternal and neonatal morbidity and mortality. All the women with multiple pregnancies and who presented with the breech in the labor room were excluded. Estimation of platelet count and renal function test were performed in order to evaluate the maternal and fetal outcomes in addition to estimation of blood glucose levels and routine investigations. Results: Of the total 148 diagnosed with gestational diabetes, the majority of women 97 (65.5%) had an age between 20 and 30 years followed by 30 to 40 years 42 (28.4%). A higher incidence of pregnancy induced hypertension 18 (12.2%), cesarean section 87 (58.8%), labor induction 58 (39.2%), macrosomia in 4 (2.7%), and preterm delivery in 5 (3.4%) was reported despite early diagnosis and treatment of gestational diabetes. The prevalence of perinatal morbidity was 43 (29.1%) whereas the mortality was 5 (3.4%). Neonatal hypoglycemia in 49 (33.1%), meconium aspiration syndrome 12 (8.1%), hyperbilirubinemia 19 (12.8%), and requirement of neonatal unit admission 37 (25%) were common causes of perinatal morbidity. Neonatal and intrauterine deaths were reported in 3 (2%) and 2 (1.4%) respectively. Conclusion: The prevalence of maternal and perinatal morbidity and mortality increased in women with gestational diabetes. A 75 g oral glucose tolerance test was used for screening of gestational diabetes in pregnant women during 24 to 28 weeks gestation which assisted in earlier diagnosis and timely intervention, in turn, reducing complications. Pregnancy outcomes might be improved with the proper management of gestational diabetes. Keywords: Maternal outcome, Perinatal outcomes, Gestational diabetes

Estimation of impedance platelet count and mean platelet volume in cases of severe microcytosis – A prospective study

Introduction: Microcytosis is a condition in which red blood cells are unusually small as measured by their mean corpuscular volume.1 The most common cause of microcytosis is iron deficiency anemia.2 In severe microcytosis, both thrombocytosis and thrombocytopenia may be seen although thrombocytosis is more frequently seen. Aim and Objectives: To study the values of platelet count and mean platelet volume in cases of severe microcytosis. Materials and Methods: A 1 year prospective study (1st January 2017 to 31st December 2017) of 200 patients was carried out in the Post Graduate Department of Pathology, Acharya Shri Chander College of Medical Sciences (ASCOMS) and Hospital, Sidhra after obtaining due clearance from Institutional Ethical Committee. Platelet count and mean platelet volume (MPV) of 200 patients with low mean corpuscular volume (MCV) was done. Results: A total of 200 patients with severe microcytosis (MCV

A STUDY ON CHANGES IN PLATELET COUNT AND PLATELET INDICES IN PATIENTS WITH PREECLMPSIAAND ECLAMPSIA: A CASE CONTROL STUDY

Preeclampsia is a hypertensive pregnancy specific multisystem disorder. It requires prompt intervention that may include observation in tertiary care setting and termination of pregnancy either by inducing labour or by caesarian section. To study the variation of platelet counts, platelet indices in preeclampsia and eclampsia Department of Pathology and Gynaecology &amp; Obstetrics Ramakrishna Mission Seva Pratisthan, Vivekananda Institute of Medical Sciences from January 2017 to June 2018. Group I: Women affected with convulsion and having signs of preeclampsia during pregnancy or within seven days after delivery after ruling out epilepsy or any other convulsive disorder were treated as eclamptic women. Group II: Women having BP&gt; 140/90 mmhg and significant proteinuria (&gt;300mg/24hrs) and or edema are treated as preeclampsia. Group III: Normotensive women having pregnancy &gt;20weeks were considered as control group. Total sample size was 66 pregnant women. 22 patients are taken from each group. The platelet indices e.g. MPV, PDW and also PLCR are in consistent relationship with PIH. The higher their values, the greater severity of PIH, from preeclampsia to eclampsia. The estimation of platelet count and indices offer early, simple, rapid assessments of the disease for its severity and the risk of complications. Therefore these tests may be considered as screening tests to be routinely performed in antenatal workup of women with PIH.

Influence of ABO Blood Group on Fibrinogen Levels and Platelet Count in Apparently Healthy Nigerian Subjects

A total of hundred (100) apparently healthy young adult male and female participants comprised of 25 subjects of blood group A, B, AB and O respectively were recruited for this study. Five milliliters of blood was collected and used for the estimation of fibrinogen levels, platelet count and ABO blood grouping using standard laboratory methods. Statistical package for social science (SPSS) version 20 was employed in the analysis of the data.

THROMBOCYTOPENIA IN PREGNANCY AND ITS CORRELATION WITH MATERNAL AND FETAL OUTCOME

Introduction-Thrombocytopenia during pregnancy is an under investigated condition in Indian ladies and is frequently underdiagnosed. Beside paleness, thrombocytopenia is the most widely recognized hematological condition happening during pregnancy and influences 7–8 % of all pregnant women Aim To study the relationship between thrombocytopenia in pregnancy associated with various causes and its effects on fetal and maternal outcomes. Material And Method The current studywas a 2 year prospective study which was carried out in the Haematology section of Pathology Department in a tertiary care hospital . Blood samples of inpatients as well as outpatient pregnant women having platelet count less than 1.5 lakhs /mm3 in the third trimester were screened and included in the study. Results Out of 275 thrombocytopenic cases, 68.73% (189 cases) had mild thrombocytopenia,132/275 (48%) belonged to the age group of 23-27 years.Etiological factors causing maternal thrombocytopenia in this study were gestational thrombocytopenia (64.73%) i.e.178/275 cases, The mean platelet count in cases of gestational thrombocytopenia was 1,09620 ± 26130.25/mm3. Maximum number of cases in this study were primigravidae i.e. 156 /275cases (56.73%) Chi square test result (p value < 0.05) was statistically significant. Among 13 cases of eclampsia, 9/13 cases i.e. (69.23%) delivered preterm. Low birth weight was observed in 28/53 cases i.e. (52.83%) of pre- eclampsia cases, One case of 32 years died due to acute fatty liver of pregnancy. Conclusions Platelet count estimation and peripheral blood smear examination can help to assess the severity of disease causing maternal thrombocytopenia and thus can reduce both the maternal and fetal complications if detected and treated early in the course of the illness. Thus, serial estimation of platelet count in pregnant women having thrombocytopenia has a great impact in reducing maternal and fetal morbidity and mortality.