Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy

Abstract

Introduction: Mean platelet volume (MPV), platelet count (PC), and red cell distribution width (RDW) are various blood indices that play important role in preeclampsia. This study aimed to evaluate the role of MPV, RDW, and PC for the prediction of preeclampsia in the early second trimester of pregnancy and to observe its correlation with disease severity. Material and Methods: A prospective case-control study was conducted for 1 year in the Department of Obstetrics and Gynecology. A total of 543 healthy pregnant women were recruited, after obtaining informed consent and ethical clearance and followed till 6 weeks postpartum, 43 were lost to follow-up. Out of 500 women, nonsevere preeclampsia (NSPE) occurred in 16 women and severe preeclampsia (SPE) in 34 women. Around 51 healthy normotensive pregnant women were recruited after systematic randomization from the same cohort, who had not developed the disease, served as controls. NSPE and SPE were defined as per ACOG 2013b guideline. MPV, RDW, and PC were measured two times by the Siemens Advia analyzer; the first samples were withdrawn at the time of enrolment and the next sample was taken after the development of the disease, and both samples were analyzed. Results: MPV was increased with the severity of preeclampsia, diagnostic accuracy was 69.4%, at a cutoff value of ≥9.05 fl and MPV discriminated controls and NSPE with 50.0% sensitivity and 82.4% specificity. To discriminate between controls and SPE, diagnostic accuracy was 74.6% at a cutoff value of ≥9.05 fl, with a sensitivity of 50%. For control versus SPE, MPCs at the cutoff value of ≥2.085 lac/mm 3 had sensitivity 52.9% and specificity 66.7%, and diagnostic accuracy 61.2%. For RDW NSPE, at a cutoff value of ≥11.5%, it discriminated against controls and NSPE with 85.3% sensitivity and 49.0% specificity. Conclusion: NSPE, MPV, RDW, and PCs had good discriminatory value with the severity of the disease.

Proteomics and Metabolomics Profiling of Platelets and Plasma Mediators of Thrombo-Inflammation in Gestational Hypertension and Preeclampsia

“…This leads to increased platelet turnover and can result in the higher immature platelet fraction (IPF) with increased mean platelet volume (MPV) that accompanies the thrombocytopenia in healthy pregnancies. However, pathologic exacerbation of this innate platelet activation in GH and PE may account for the higher MPV and IPF seen in our small cohort, and as reported by others [53,62,63].…”

Study of Some Hematological Markers of Systemic Inflammatory Response in Preeclampsia

“…As well, Sachan et al [16], reported that neutrophil was significantly high in Severe PE group in comparison to the mild group. However, there was no statistically significant difference between the two preeclampsia groups as regard Hemoglobin, Lymphocyte, platelets, MPV and RDW.…”

“…NLR showed a non-significance with AUC 0.557 P-value 0.097 at cut-off value 5.05. While Sachan et al [16], reported that the best predictor of PE was MPV with AUC 0.643 and Pvalue 0.002 at a cutoff value of ≥9.05 fl with 50.0% sensitivity and 82.4% specificity. While RDW, at a cut-off value of ≥11.5% had AUC 0.751 and P-value 0.001 with 85.3% sensitivity and 49.0% specificity.…”

“…3) Investigation: Complete blood picture with the systemic inflammatory response markers: Samples for complete blood count with differentials including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width, (RDW), mean platelet volume (MPV), plateletcrit value (PCT) were obtained at the admission of the patients to the department, before the initiation of any medical treatment [16]. Other routine investigations in preeclampsia: Prothrombin time, partial thromboplastin time and international normalized ratio, Liver functions including SGOT and SGPT, Renal functions including urea and creatinine, urine analysis for presence of albumin and routine ultrasound for assessment of fetal growth, and amniotic fluid [16]. Statistical Methods: The collected data will be, tabulated, and statistically analyzed using SPSS program (Statistical Package for Social Sciences) software version 26.0, Microsoft Excel 2016.…”

Diagnostic biomolecules and combination therapy for pre-eclampsia

“…If PI and MAP are used synergistically with mathematically calculating PE risks using maternal characteristics, it will exhibit a high detection rate of 89% for early-onset PE, but still only 57% for late-onset PE at a FPR of 10% [ 18 ]. Since PE-induced pulmonary embolism commonly causes increased levels of mean platelet volume (MPV) and red cell distribution width (RDW), the blood tests detecting platelet count, mean platelet volume, and red cell distribution width have been raised as significant markers of PE [ 19 , 20 ]. Although hemo-diagnosis possesses several advantages of fast and low-cost, their specificity and sensitivity are still unsatisfactory.…”