Assessment of the hematological profile in neonates borne to sever pre eclamptic mothers (single center study)

Abstract

Background: Preclampsia is a common disease unique to human pregnancy representing a challenge to obstetricians and neonatologists because of its serious effects on the mothers and babies. We aimed to evaluate hematological and coagulation aspects in newborns of preeclamptic mothers Patients and methods: Sixty (30 full and 30 preterm) neonates delivered to hypertensive mothers and another 30(15 full term and 15 preterm) babies of healthy normotensive mothers were as controls were enrolled. Detailed history taking and full clinical examination were done stressing on parity, mode of delivery, birth weight, APGAR score at o and five minutes and gestational age. All enrolled neonates were subjected to complete blood count (hb,ht,mcv, mch, wbcs, plates), pt, pc and ptt. Results:In full term babies of preeclamptic mothers, primigravida were 70% compared to 20% in controls while In preterm group, prmigravida mothers were 80% compared to 33.3% in controls (p=0.001). Cesarean section was the predominant mode of delivery in preterm neonates to preclamptic mothers (76.6% compared to 13.3% in controls while in full term group, cesarean section was 53.3 % compared to 86.3% for the controls. Sever preeclampsia comprised 80% of mothers of pre term infants versus 33.3% in mothers of term infants APGAR score was lower in infant of preclamptic mothers. RBCs number were and hemoglobin levels were significantly higher in neonates of preclamptic mothers (either term or preterm) than the control (p=0.001) while WBCs were significantly lower in neonates of preclamptic mothers (10.7±2.1,10.8±2.2 and 13.1±1.9,13±1.7respectively) ( p=0.001).Platelets numbers were significantly low in cases (186.1 ±91.5, 133.7 ±58.9) and 223.1 ± 43.4 and 216.4±51.8. Coagulation profile is significantly impaired PT, PTT 28.03±6.9, 21.7±3.1in cases and 14.1±1.8 and13.4±1.5 in controls (p=0.001). Prothrombin concentration was significantly lawer in cases (43.21±78, 61±7.7) compared to controls (70±3.5, 74.2±1.9). Conclusion:Neonates borne to preeclamptic mothers are more susceptible to impaired global coagulation status which is more expressed in preterm babies.

Faktor Risiko Terhadap Kejadian Gangguan Koagulasi pada Neonatus

“…12 Pada penelitian ini terdapat rerata peningkatan PT dan PTTK. Dengan uji bivariat chi square, preeklampsia 13 sejalan dengan penelitian ini, rerata PT dan PTTK, lebih tinggi pada bayi dari ibu preeklampsia dibanding bayi normal. Pemanjangan PT dan PTTK terjadi karena ketidakseimbangan antara koagulasi dan fibrinolisis pada area vaskular terutama sirkulasi uteroplasenta.…”

Hematological Profile of Neonates Born to Mother with Pregnancy Induced Hypertension Presenting at Tertiary Care Hospital

“…1 The National High Blood Education Program (NHBPEP) is an organization that classifies this condition into five distinct categories: (1) long-term high blood pressure, (2) high blood pressure developed during pregnancy, (3) pre-eclampsia condition, (4) eclampsia syndrome, and (5) the occurrence of preeclampsia on top of existing chronic high blood pressure. [2][3][4] These diseases complicate 10-15% of all pregnancies, but it is estimated that this proportion is higher in underdeveloped counties due to a variety of reasons like inadequate care during prenatal period, poverty and poor health awareness. [3][4][5][6] Pregnancy induced hypertension (PIH) is culpable for death during pregnancy and neonatal period of 10% and 40-50% of low birth weight newborns.…”

“…[2][3][4] These diseases complicate 10-15% of all pregnancies, but it is estimated that this proportion is higher in underdeveloped counties due to a variety of reasons like inadequate care during prenatal period, poverty and poor health awareness. [3][4][5][6] Pregnancy induced hypertension (PIH) is culpable for death during pregnancy and neonatal period of 10% and 40-50% of low birth weight newborns. 7 In the industrialized world, 16.1% of maternal mortality is attributed to hypertensive diseases and continues to contribute significantly to global maternal mortality.…”

“…Therefore, neonates of hypertensive mothers increase the chance to develop intrauterine death, preterm and premature birth, transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS), persistent pulmonary hypertension(PPHN), bronchopulmonary dysplasia(BPD), respiratory failure, perinatal asphyxia, neonatal infections, bleeding complications and hematological abnormalities, such as low platelets counts,increased concentration of haemoglobin , and decrease neutrophils counts in blood. 1,[3][4][6][7][10][11][12][13] Physiological changes in pregnant women are neutrophilic leukocytosis, hyperlipidemia, procoagulant, and hypofibrinolytic changes. Physiological changes and placental abnormalities in hypertensive mothers that lead to fetal and neonatal complications…”