RELEVANCE OF MEASUREMENT OF HEMATOLOGICAL PARAMETERS IN SUBJECTS WITH PREGNANCY INDUCED HYPERTENSION
Background: The pregnancy induced hypertensive (PIH) mothers are at greater risk for intrauterine growth restriction (IUGR) and intrauterine death of foetus (IUD). But currently there are no suitable early indicators of PIH mothers at risk of IUGR and IUD.
Aims/objectives: To assess the various routinely measured hematological parameters in assessment of PIH mothers at risk of IUGR and IUD.
Methods: This was a retrospective study done in singleton mothers. Study Group: 75 subjects with PIH. They were divided in to: Group A (n=35): PIH subjects with IUGR and IUD. Group B (n=40): PIH subjects without IUGR and IUD. Controls: 62 normotensives. Blood parameters measured were: platelets, packed cell volume (PCV), hemoglobin, erythrocyte sedimentation rate (ESR), differential leucocyte count. Statistical analysis was done by ANOVA and Bonferroni test. P<0.05 was taken as significant.
Results: Among the measured blood parameters, platelet count was lower in group A and group B compared to control (p<0.0001). Platelets were also lower in group A compared to group B (p<0.0001). Hemoglobin and PCV were lower in group A compared to controls and group B (p<0.001). Monocytes and ESR were lower in group A and group B compared to controls (p<0.05, p<0.001 respectively). Neutrophils were lower in group A compared to control (p<0.05). Other pairwise comparisons did not differ significantly.
Conclusions: Platelet count may be a suitable marker in monitoring subjects with PIH at risk of IUGR and IUD. Anemia may be associated with IUD and IUGR in PIH patients.
24. April 2020 (online)
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- 1 Sullivan CA, Martin JN. Management of the obstetric patient with thrombocytopenia. Clin Obstet Gynecol 1995; 38: 521-34.
- 2 Cunningham FG, Kerneth JLleveno, Steven L. Bloom et al: Hypertensive Disorders in Pregnancy. In Williams Obstetrics.Iinternational edn, New york : Mcgraw hill; 2001; chp-34, p. 567– 618.
- 3 Ferrazzani S, Luciano R, Garofalo S, D'Andrea V, De Carolis S, De Carolis MP, Paolucci V, Romagnoli C, Caruso A. Neonatal outcome in hypertensive disorders of pregnancy. Early Hum Dev. 2011; 87(6): 445-49.
- 4 Michelle Hladunewich, S Ananth Karumanchi, Richard Lafayette. Pathophysiology of the Clinical Manifestations of Preeclampsia. Clin J Am Soc Nephrol 2007; 2: 543-49.
- 5 Pollak VE, Nettles JB. The kidney in toxemia of pregnancy: a clinical and pathologic study based on renal biopsies. Medicine (Baltimore) 1960; 39: 469–52.
- 6 Lao TT, Chin RK, Lam YM. The significance of proteinuria in preeclampsia; proteinuria associated with low birth weight only in preeclampsia. Eur J Obstet Gynecol Reprod Biol 1988 ;29 (2):121-27.
- 7 Newman MG, Robichaux AG, Stedman CM, Jaekle RK, Fontenot MT, Dotson T, Lewis DF. Perinatal outcomes in preeclampsia that is complicated by massive proteinuria. Am. J. Obstet. Gynecol 2003; 188(1), 264–68.
- 8 Thangaratinam S, Coomarasamy A, O'Mahony F, Steve Sharp S, Zamora J, Khalid S Khan KS, Ismail KMK. Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review. BMC Medicine 2009; 7:10.
- 9 Egwuatu VE. Plasma concentration of urate, urea and creatinine in Nigerian primigravidae with pre-eclampsia. Trop Geogr Med 1986; 38:11-15.
- 10 Mustaphi R, Gopalan S, Dhaliwal L, Sarkar AK. Hyperuricemia and pregnancy induced hypertension-reappraisal. Indian J Med Sci 1996, 50: 68- 71.
- 11 Shehata N, Burrows R, Kelton JG. Gestational thrombocytopenia. Clin Obstet Gynecol 1999; 42: 327- 34.
- 12 Zhang Q, Li Z, Ananth CV. Prevalence and risk factors for anaemia in pregnant women: a population-based prospective cohort study in China. Paediatr Perinat Epidemiol. 2009; 23(4):282-91.
- 13 Manjareeka M, Nanda S. Elevated levels of serum uric acid, creatinine or urea in pre-eclamptic women. Int J Med Sci Public Health 2013; 2(1): 43-47.
- 14 Sivakumar S, Bhat BV, Badhe BA. Effect of pregnancy induced hypertension on mothers and their babies. Indian J Pediatr 2007;74(7):623-25.
- 15 Levine RJ, Lindheimer MD: First-trimester prediction of early preeclampsia: a possibility at last! Hypertension 2009; 53(5): 747–48.
- 17 Cnossen JS, Vollebregt KC, Vrieze ND, Riet GT, Ben W J Mol , Franx A. Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis. BMJ 2008; 336: 1117.
- 16 Wakwe VC, Abudu OO. Estimation of plasma uric acid in pregnancy induced hypertension (PIH). Is the test still relevant? Afr J Med Med Sci 1999; 28 (3-4):155-58.
- 18 Hawkins TL, Roberts JM, Mangos GJ, Davis GK, Roberts LM, Brown MA. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective cohort study. BJOG 2012; 119(4):484-92.
- 19 Mustaphi R, Gopalan S, Dhaliwal L, Sarkar AK. Hyperuricemia and pregnancy induced hypertension—reappraisal .Indian J Med Sci 1996; 50 (3):68-71.
- 20 Hickman PE, Michael CA, Potter JM. Serum uric acid as a marker of pregnancy-induced hypertension. Aust N Z J Obstet Gynaecol. 1982; 22 (4):198-202.
- 21 Salako BL, Odukogbe AT, Olayemi O, Adedapo KS, Aimakhu CO, Alu FE, Ola B. Serum albumin, creatinine, uric acid and hypertensive disorders of pregnancy. East Afr Med J 2003; 80(8):424-28.
- 22 Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for leukocytosis in women with preeclampsia. Am J Perinatol 2009; 26 (10):729-32.
- 23 Schiessl B. Inflammatory response in preeclampsia. Mol Aspects Med 2007; 28 (2):210-19.
- 24 Zhang Q, Li Z, Ananth CV. Prevalence and risk factors for anaemia in pregnant women: a population-based prospective cohort study in China. Paediatr Perinat Epidemiol 2009; 23(4):282-91.
- 25 Nazli R, Khan MA, Akhtar T, Mohammad NS, Aslam H, Haider J. Frequency of thrombocytopenia in pregnancy related hypertensive disorders in patients presenting at tertiary care hospitals of Peshawar. Khyber Med Univ J 2012; 4 (3):101-105.
- 26 Rahim R, Nahar K, Khan IA. Platelet count in 100 cases of pregnancy induced hypertension. Mymensingh Med J. 2010; 19 (1):5-9.
- 27 Hossain N, Shah N, Khan N, Lata S, Khan NH. Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy at a Tertiary Care Hospital. J Dow Univ Health Sci 2011; 5(1): 12-16.