a SciTechnol journal Research Article
Mohammed et al., J Physiobiochem Metab 2013, 2:1
http://dx.doi.org/10.4172/2324-8793.1000106
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Journal of
Physiobiochemical
Metabolism
Variations of Platelets
Indices in Pregnancy Induced
Hypertension
Fahmi Elsir Mohammed
1
, Hiba Badreldin Khalil
2
, Mubarak
Ibrahim Idriss
3
, Tag Eldien Mohamadein Abdalla
4
and
NourEldaim Elnoman Elbadawi
4
*
Abstract
Pregnancy induced hypertension (PIH), are high blood pressure
disorders of pregnancy. Previous studies revealed that hemoglobin
concentration decreased and white cell count increased during
pregnancy. There is less records regarding change in platelets
count with pregnancy induced hypertension (PIH).The aim of this
study is to find out the relationship between platelet indices and
platelet count among pregnant women with PIH. The study showed
that platelet count was decreased compared to normal control
while the mean platelet volume & platelet distribution width were
increased. We concluded that, there is a relationship between
platelet indices and PIH. The estimation of platelet indices must be
considered as an early, simple and rapid routine test as a strategy
for assessment of PIH during pregnancy.
Abbreviations
PIH: Pregnancy-induced Hypertension; HELLP syndrome:
Haemolysis Elevated Liver Enzymes Low Platelet; PL: Platelets count;
MPV: Mean Platelets Volume; PDW : Platelet Distribution Width;
EDTA: Ethylenediaminetetraacetic acid; G
x
: Group; BP: Blood
Pressure; Yrs: years
Introduction
Pregnancy-induced Hypertension (PIH) is a syndrome of
hypertension with proteinuria (Pre-eclampsia) or without proteinuria
and edema, with the clinical manifestation usually occurring late in
pregnancy and regressing aſter delivery of the conceptus. It is a major
pregnancy complication, causing premature delivery, fetal growth
retardation, abruption placenta, and fetal death, as well as maternal
morbidity and mortality [1]. When blood pressure rises in pregnancy
with significant protein in urine is called Preeclampsia [2], while
Eclampsia (is word means a fever of rapid onset) [3] is a dangerous
complication of pregnancy with a sudden onset and has the features
of developing tonic-clonic fits in a patient who have developed
preeclampsia. Preeclampsia and eclampsia are collectively called
hypertensive disorders or toxemia of pregnancy [4]. ere are various
theories to clarify eclampsia and pre-eclampsia and it is proposed
that hypo perfusion of placenta is the main factor responsible for
the disease process. Maternal blood vessels become more sensitive
to pressure agents causing constriction of blood vessels and hypo
perfusion in various organs. Furthermore the condition is aggravated
by the activation of coagulation chain causing micro thrombi
formation. Edema developed by release of plasma into extra vascular
tissues that further worsen the condition. ese changes cause signs
and symptoms of eclampsia as well as hypertension, renal, hepatic,
and pulmonary dysfunction specifically cerebral dysfunction [5]. On
the other hand endothelial activation and altered platelet counts are
the markers of the disease progression before the development of sign
and symptoms [5].
Moreover most of the cases are suggested that shallow
implantation of placenta becomes hypoxic and causes immune
reaction [6]. In pregnancy induced hypertension, the most frequent
hematological abnormality found is thrombocytopenia. e degree
of thrombocytopenia increases with severity of disease [7]. In the
pregnant women, thrombocytopenia is defined as a platelet count
of less than 150×10
9
L. Counts of 100–150×10
9
L are defined as
mild thrombocytopenia and counts of 50–100×10
9
L as moderate
thrombocytopenia, while counts of less than 50×10
9
L known as severe
thrombocytopenia. rombocytopenia is caused either by increased
platelet destruction or decreased platelet production. In pregnancy,
increased platelet destruction may be mediated by immunological
mechanisms, abnormal platelet activation, or platelet consumption
[8]. Increased destruction or utilization of platelets during pregnancy
occurs in microangiopathies (exposure to abnormal blood vessels)
such as thrombotic thrombocytopenic purpura, haemolytic uraemic
syndrome, haemolysis, elevated liver enzymes, low platelet (HELLP)
syndrome, and pre-eclampsia.
Materials and Methods
A prospective analytical case - control study conducted in Sudan,
Khartoum state at Omdurman Maternity Hospital (OMH), from
Jan to June, 2012. Sixty pregnant women proved to have PIH were
recruited and classified into 3 groups based on the severity of the
disease as:
Group one (Mild PIH): with systolic blood pressure (140- 160
mmHg), diastolic blood pressure (90 - 110 mmHg) and without
protein in urine.
Group 2 (preeclampsia): with systolic blood pressure less than
170 mmHg and diastolic blood pressure less than 130 mmHg and
association with protein in urine (>300 mg).
Group 3 (eclampsia group): Blood pressure greater than 160/110
mmHg, with protein in urine (>5 gm).
Furthermore, 20 healthy women selected as control enrolled in
the study aſter obtaining informed consent from them.
Exclusion criteria’s
Diabetic patients, patients on plavix therapy, anaemia or
haemoglobinopathy, renal failure and chronic inflammatory disease
were excluded from the study.
An EDTA venous blood was analyzed within 2-6 hours to
*Corresponding author: NourEldaim Elnoman Elbadawi, Department of
Biochemistry, Faculty of Medicine & Health Sciences, University of Kassala,
Kassala, Sudan, E-mail: noureldaim@hotmail.com
Received: April 03, 2013 Accepted: July 15, 2013 Published: July 24, 2013