414 Bali Medical Journal 2022; 11(1): 414-417 | doi: 10.15562/bmj.v11i1.3246 ORIGINAL ARTICLE ABSTRACT The diference of platelet-white blood cell ratio in severe preeclampsia and normotensive pregnancy Nisrina Aisyah Nur Safrani 1 , Faizah Fulyani 2 , Putri Sekar Wiyati 3 , Besari Adi Pramono 3* Background: Infammation is believed to play a role in preeclampsia. Leukocytes increase due to infammatory response. Endothelial damage in preeclampsia induces platelet aggregation, triggers platelet consumption, and decreases platelet. Therefore, preeclampsia could alter the platelet-white blood cell ratio, which can be used as a marker for preeclampsia. This study examines the diference of platelet-white blood cell ratio in severe preeclampsia and normotensive pregnancy. Methods: This study used the medical records of pregnant women in Dr. Kariadi General Hospital Semarang from 2019 to 2020. Samples were collected using a consecutive sampling method. Data were analyzed using an independent t-test and Mann-Whitney. Results: There was a signifcant diference in platelet count (p=0.011) and leukocyte count (p=0.018) between severe preeclampsia and normotensive pregnancy. Therefore, a diference (p<0.01) in platelet-white blood cell ratio between severe preeclampsia and normotensive pregnancy was observed. Conclusion: Platelet-white blood cell ratio in severe preeclampsia is 0.7 times lower than in normotensive pregnancy. Keywords: infammation, severe preeclampsia, platelet-white blood cell ratio. Cite This Article: Safrani, N.A.N., Fulyani, F., Wiyati, P.S., Pramono, B.A. 2022. The diference of platelet-white blood cell ratio in severe preeclampsia and normotensive pregnancy. Bali Medical Journal 11(1): 414-417. DOI: 10.15562/bmj.v11i1.3246 1 Undergraduate Program, Faculty of Medicine, Universitas Diponegoro; 2 Department of Biology and Biochemistry, Faculty of Medicine, Universitas Diponegoro; 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Diponegoro; *Corresponding author: Besari Adi Pramono; Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Diponegoro; babas1504@yahoo.com Received: 2022-02-27 Accepted: 2022-04-05 Published: 2022-04-18 414 Bali Medical Journal (Bali MedJ) 2022, Volume 11, Number 1: 414-417 P-ISSN.2089-1180, E-ISSN: 2302-2914 Open access: www.balimedicaljournal.org INTRODUCTION According to World Health Organization (WHO), Global Maternal Mortality Rate in 2017 reached 211 per 100,000 live births. 1 In Indonesia, Maternal Mortality Rate in 2019 called 305 per 100,000 live births. 2 Direct obstetric causes of maternal death in Indonesia are bleeding (28%), preeclampsia/eclampsia(24%), and infection (11%). 3 It should be noted that preeclampsia incidence in developing countries is seven times higher than in developed countries, with the number of preeclampsia found in Indonesia to be 7- 10% of all pregnancies. 4 Te etiology and mechanism of preeclampsia are still unknown up to this day, making this disease “the disease of theories”. 5 One of the theories states that preeclampsia is caused by the failure of the trophoblast invasion process, which leads to hypoperfusion and ischemic of the placenta. Tis, in turn, will create destruction of endothelial cells and induce vasospasm, thrombocytes aggregation, and thrombocytes usage. 6 Angiogenesis imbalance and systemic infammation are believed to play a role in the etiopathogenesis of preeclampsia. 7 Te infammatory response in preeclampsia involves leukocyte activation, and leukocytes are found to be increased due to the infammatory response. 8 Platelet-Lymphocyte Ratio (PLR) and Neutrophil-Lymphocyte Ratio (NLR) are potential markers for predicting infammation. Research conducted in Boston reported that PLR has a crucial role in infammation. 9 Another study in Antwerp University Hospital found that PLR levels are lower while NLR levels are higher in preeclampsia. 10 Platelet-white blood cell ratio (PWR) refers to the hematologic marker of systemic infammatory response. 11 Other research reported the potential of PWR as an additional test for preeclampsia screening and adjuvant fetal health test during antepartum due to its simplicity and convenience. 12 Terefore, this study’s objective was to confrm the diference between PWR in preeclampsia and normotensive birth, especially among Indonesian pregnant women. METHODS Study Design Tis research is an observational analytic study with a cross-sectional approach. Data collected in this research are secondary data from medical records of pregnant patients in Dr. Kariadi General Hospital. Te sample was chosen through consecutive sampling. Te inclusion criteria were pregnant patients admitted to Dr. Kariadi General Hospital during 2019-2020, preeclampsia with severe features, gestational age above 20 weeks, and single pregnancy. Exclusion criteria of this research are incomplete or unreadable medical records, history of diabetes mellitus, Coronavirus Disease 2019 (COVID-19), autoimmune, renal, heart, liver, and infectious disease. In total, 45 patients with severe preeclampsia and 45 control patients were analyzed. Te Independent variable in this study is severe preeclampsia, while the dependent variable is the platelet-white blood cell ratio.