101 KMUJ 2012; Vol. 4, No. 3: 101-105 FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY RELATED HYPERTENSIVE................ C K C K C K C K ORIGINAL ARTICLE INTRODUCTION INTRODUCTION INTRODUCTION INTRODUCTION INTRODUCTION Thrombocytopenia is second only to anemia ob- served as the most common hematological abnormality during pregnancy. The overall prevalence of thrombocy- topenia in pregnancy is 8% 1 . Hypertensive disorders ac- counts for 21% of cases of thrombocytopenia in preg- nancy 2 . The causes of thrombocytopenia from preg- nancy-induced hypertension and HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome are unknown. One explanation is that it might be initi- ated by microvascular damage that results in platelet activation. Degranulation of the platelets is followed by vasospasm and further endothelial damage 3 . The only known therapy for this cycle is delivery of the fetus. Thrombocytopenia occurs more commonly in patients with eclampsia (30%) compared to patients with both mild and severe forms of pre-eclampsia (15%-18%). 1 Recent studies have documented that increased plasma levels of soluble vascular endothelial cell growth factor (VEGF) receptor type 1 (sFlt1) 4 , as well as endoglin, an endothe- lial cell-derived member of the tumor growth factor-² (TGF-²) receptor family 5 , are present in patients intended to develop preeclampsia as early as the late first trimes- ter. Increased levels of sFlt1 and endoglin mRNA are present in preeclamptic placentae, suggesting this is the source of these proteins 4,6 . sFlt1 binds and neutralizes FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY FREQUENCY OF THROMBOCYTOPENIA IN PREGNANCY RELA RELA RELA RELA RELATED HYPERTENSIVE DISORDERS IN P TED HYPERTENSIVE DISORDERS IN P TED HYPERTENSIVE DISORDERS IN P TED HYPERTENSIVE DISORDERS IN P TED HYPERTENSIVE DISORDERS IN PATIENTS TIENTS TIENTS TIENTS TIENTS PRESENTING A PRESENTING A PRESENTING A PRESENTING A PRESENTING AT TERTIARY CARE HOSPIT T TERTIARY CARE HOSPIT T TERTIARY CARE HOSPIT T TERTIARY CARE HOSPIT T TERTIARY CARE HOSPITALS OF PESHA ALS OF PESHA ALS OF PESHA ALS OF PESHA ALS OF PESHAWAR AR AR AR AR Rubina Nazli Rubina Nazli Rubina Nazli Rubina Nazli Rubina Nazli 1 , Mohammad Akmal Khan , Mohammad Akmal Khan , Mohammad Akmal Khan , Mohammad Akmal Khan , Mohammad Akmal Khan 2 , T , T , T , T , Tasleem Akhtar asleem Akhtar asleem Akhtar asleem Akhtar asleem Akhtar 3 , Nabila Sher Mohammad , Nabila Sher Mohammad , Nabila Sher Mohammad , Nabila Sher Mohammad , Nabila Sher Mohammad 4 , Hina Aslam , Hina Aslam , Hina Aslam , Hina Aslam , Hina Aslam 4 , Jamila Haider , Jamila Haider , Jamila Haider , Jamila Haider , Jamila Haider 5 ABSTRACT ABSTRACT ABSTRACT ABSTRACT ABSTRACT Objective: To find the frequency of thrombocytopenia in women with pregnancy related hypertensive disorders in patients presenting at tertiary care hospitals of Peshawar. Methodology: This cross sectional study was conducted from January 2009 to January 2010 in the tertiary referral health care facilities of Peshawar. A total of 312 women of gestational age of >20 weeks with pregnancy related hypertensive disorders were investigated. They were subdivided into 102 women with gestational hypertension (Group A), 100 women with pre-eclampsia (Group B), and 110 women with eclampsia (Group C). Ninety healthy pregnant women (group D) were chosen as control. All the subjects were selected from the Gynecology and Obstetrics units of three tertiary health care facilities of Peshawar. Platelet count was measured by using Hematology Analyzer. The data was processed on SPSS version 10. Results: The frequency of thrombocytopenia in all patient groups was 21.8% (n=68/312). Individual groups showed thrombocytopenia in 14.6% (Group A), 15% (group B), 34.6% (group C) and 4.5% in controls (group D). Out of 68 patients with thrombocytopenia, 38(55.9%) were eclamptic. Overall severe thrombocytopenia was recorded in 27(8.7%) patients, of whom 15(55.6%) were eclamptic. These patients were nine times more likely to have eclampsia as com- pared to those having platelet count > 150,000/µL (OR: 9.41; CI: 1.33-188.8; p= 0.008). Conclusion: A high frequency of thrombocytopenia was recorded in the patients with pregnancy related hypertensive disorders in the tertiary care hospitals of Peshawar. The severity of thrombocytopenia is proportional to the severity of pregnancy related hypertensive disorders. Key Words: Pregnancy Related Hypertensive Disorders; Platelet Count; Thrombocytopenia; Gestational Hyperten- sion, Pre-Eclampsia. This article may be cited as: Nazli R, Khan MA, Akhtar T, Mohammad NS, Aslam H, Haider J. Frequency of thromb- ocytopenia in pregnancy related hypertensive disorders in patients presenting at tertiary care hospitals of Peshawar. Khyber Med Univ J 2012;4(3):101-105. 1 Institute of Basic Medical Sciences (IBMS), Khyber Medical University, Peshawar, Pakistan 2 Khyber Teaching Hospital, Peshawar, Pakistan 3 PMRC Research Centre, Khyber Medical College, Peshawar, Pakistan 4 Khyber Girls Medical College, Peshawar, Pakistan 5 Frontier Women University, Peshawar, Pakistan Address for Correspondence: Dr Rubina Nazli Dr Rubina Nazli Dr Rubina Nazli Dr Rubina Nazli Dr Rubina Nazli Associate Professor of Biochemistry Institute of Basic Medical Sciences (IBMS), Khyber Medical University, Peshawar, Pakistan Ph. No: 92-91-9217703; Cell No: 03215773696 Email: drrubinanazli.ibms@kmu.edu.pk; rubinanazli44@gmail.com Date Submitted: May 11, 2012 Date Revised: September 26, 2012 Date Accepted: September 27, 2012