Investigation of Mean Platelet Volume and Dipper/ Non-dipper Status in preeclamptic women during pregnancy and postnatal period

Year 2007, Volume: 8 Issue: 3, 49 - 53, 01.12.2007

Dağıstan Tolga Arıöz Emine Coşar Reha Demirel Gülengül Köken

Abstract

Keywords

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Preeklamptik Kadınlarda Gebelik ve Postnatal Periyotta Ortalama Platelet Volümü ve Dipper/Non-Dipper Durumunun Araştırılması

Abstract

Amaç: Amacımız dipper ve non-dipper preeklamptik kadınlar arasında, gebelikte ve postnatal periyotta ortalama platelet volümü (MPV) değişikliklerini saptamaktı. Gereç ve Yöntem: Dipper durumuna sahip 17 preeklamptik kadın ve non-dipper durumuna sahip 12 preeklamptik kadına karşılık 30 normotansif gebe kadınla çalışmayı gerçekleştirdik. Referans bilgisi sağlamak için doğumdan 6 ay sonra 56 kadın ile tekrar çalışıldı. Osilometrik cihazla 24 saat ambulatuar kan basıncı ölçüldü. Dipping profili, noktürnal kan basıncında %10 veya daha fazla düşme olarak tanımlandı ve non-dipping profili, noktürnal kan basıncında %10’dan daha az düşme olarak tanımlandı. Tüm hastalar için HGB, HCT, PLT ve MPV düzeyleri ölçüldü. Bulgular: Dipper ve non-dipper durumuna sahip preeklamptik kadınlar, normotansif gebe kadınlara göre belirgin derecede yüksek MPV değerlerine sahipti (10.4 ± 1.3, 10.1 ± 0.9 ve 8.9 ± 1.9 fl, sırasıyla; P=0.003). Dahası, dipper ve non-dipper durumuna sahip preeklamptik kadınlar, önceden preeklamptik olan kadınlara göre belirgin derecede yüksek MPV değerlerine sahipti (10.4 ± 1.3 vs. 8.5 ± 1.2, P=0.001 ve 10.1 ± 0.9 vs. 8.5 ± 1.1 fl, sırasıyla; P=0.002). Ancak, doğumdan 6 ay sonra, MPV değerleri, 3 grup arasında istatistiksel olarak farklı değildi (8.5 ± 1.1, 8.5 ± 1.1 ve 8.9 ± 1.9 fl, sırasıyla; P=0.588). Ayrıca, MPV değerleri dipper ve non-dipper grupları arasında farklı değildi. Sonuç: Preeklampsi patogenezi preeklamptik kadınlarda yüksek MPV değerlerini açıklamada yardımcı olabilir. Bununla beraber dipper alt grupları arasında farklılık olmadığı için MPV değerlendirmesi yoluyla ek bilgi mümkün değildir

Keywords

Ortalama platelet volümü (MPV), dipper, non-dipper, preeklampsi

References

• Sibai BM. Preeclampsia as a cause of preterm and late preterm (near-term) births. Semin Perinatol. 2006;30:16-19.
• Roberts JM, Pearson G, Cutler J, Lindheimer M; NHLBI Working Group on Research on Hypertension During Pregnancy. Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension. 2003;41:437-445.
• Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:1-22.
• Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin İnvest. 2000;30:1113-1118.
• Socol ML, Weiner CP, Louis G, Rehnberg K, Rossi EC. Platelet activation in preeclampsia. Am J Obstet Gynecol. 1985;151:494-497.
• Whigham KA, Howie PW, Drummond AH, Prentice CR. Abnormal platelet function in pre-eclampsia. Br J Obstet Gynaecol. 1978;85:28-32.
• Bellomo G, Narducci P, Rondoni F, et al. Prognostic value of 24-hour blood pressure in pregnancy. JAMA. 1999;282:1447-1452.
• Walker SP, Higgins JR, Brennecke SP. Ambulatory blood pressure monitoring in pregnancy. Obstet Gynecol Surv. 1998;53:636-644.
• Jerrard-Dunne P, Mahmud A, Feely J. Circadian blood pressure variation: relationship between dipper status and measures of arterial stiffness. J Hypertens. 2007;25:1233-1239.
• Verdecchia P, Schillaci G, Guerrieri M, et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990;81:528-536.
• Fay RA, Hughes AO, Farron NT. Platelets in pregnancy: hyperdestruction in pregnancy. Obstet Gynecol. 1983;61:238-240.
• Ahmed Y, van Iddekinge B, Paul C, Sullivan HF, Elder MG. Retrospective analysis of platelet numbers and volumes in normal pregnancy and in pre- eclampsia. Br J Obstet Gynaecol. 1993;100:216-220.
• Chesley LC. Vascular reactivity in normal and toxemic pregnancy. Clin Obstet Gynecol. 1966;9:871-881.
• Roberts JM, Taylor RN, Goldfien A. Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia. Am J Hypertens. 1991;4:700-708.
• Walker JJ, Cameron AD, Bjornsson S, Singer CR, Fraser C. Can platelet volume predict progressive hypertensive disease in pregnancy? Am J Obstet Gynecol. 1989;161:676-679.
• Howarth S, Marshall LR, Barr AL, Evans S, Pontre M, Ryan N. Platelet indices during normal pregnancy and pre-eclampsia. Br J Biomed Sci. 1999;56:20-22.
• Piazze J, Gioia S, Cerekja A, et al. Doppler velocimetry alterations related to platelet changes in third trimester pregnancies. Platelets. 2007;18:11-15.
• Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost. 2003;9:177-190.
• Thompson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size and age determine platelet function independently. Blood. 1984;63:1372-1375.
• Jagroop IA, Clatworthy I, Lewin J, Mikhailidis DP. Shape change in human platelets: measurement with a channelyzer and visualisation by electron microscopy. Platelets. 2000;11:28-32.
• Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7:157-161.
• Park Y, Schoene N, Haris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13:301-306.
• Karalis I, Nadar SK, Al Yemeni E, Blann AD, Lip GY. Platelet activation in pregnancy-induced hypertension. Thromb Res. 2005;116:377-383.
• Staessen JA, Celis H, Hond ED, et al; THOP investigators. Comparison of conventional and automated blood pressure measurements: interim analysis of the THOP trial. Treatment of Hypertension According to Home or Office Blood Pressure. Blood Press Monit. 2002;7:61-62.
• Pickering TG. A review of national guidelines on the clinical use of ambulatory blood pressure monitoring. Blood Press Monit. 1996;1:151-156.
• Kitamura T, Onishi K, Dohi K, et al. Circadian rhythm of blood pressure is transformed from a dipper to a non-dipper pattern in shift workers with hypertension. J Hum Hypertens. 2002;16:193-197.
• O’Shea JC, Murphy MB. Nocturnal blood pressure dipping: a consequence of diurnal physical activity blipping? Am J Hypertens. 2000;13:601-606.
• Manning G, Rushton L, Donnelly R, Millar-Craig MW. Variability of diurnal changes in ambulatory blood pressure and nocturnal dipping status in untreated hypertensive and normotensive subjects. Am J Hypertens. 2000;13:1035-1038.