Publication:

Platelet count as a first line screening test for the detection of coagulation disorder in preeclamptic and eclamptic patients

Background Pre-eclampsia and eclampsia are major obstetric complications and important causes of maternal morbidity and mortality in developing countries. Platelet count is a simple, inexpensive, and widely available investigation that may help detect coagulation disorders in these conditions. This study aimed to determine the sensitivity and specificity of platelet count for predicting coagulation disorders in pre-eclampsia and eclampsia.

Methods This cross-sectional analytical study was conducted in the department of obstetrics and gynecology of Dhaka Medical College Hospital from June 2022 to May 2023. A total of 81 pregnant women were enrolled and divided equally into three groups: pre-eclampsia (n=27), eclampsia (n=27), and normotensive pregnancy (n=27). Platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), serum fibrinogen, and D-dimer were measured. Data were analyzed using SPSS version 26.

Results Mean platelet count was significantly lower in eclampsia (186,296.3±91,728.6/μl) and pre-eclampsia (217,777.8±77,745.3/μl) compared to normal pregnancy (252,296.3±44,155.2/μl) (p<0.001). Thrombocytopenia was observed in 38.89% of pregnancy-induced hypertension cases. For detecting coagulation disorders, platelet count showed sensitivity of 45.45% and specificity of 90.00% in eclampsia, while sensitivity and specificity in pre-eclampsia were 46.51% and 81.82%, respectively.

Conclusions Platelet count alone is not a reliable screening test for coagulation disorders in pre-eclampsia and eclampsia.