Is there any relation between intrauterine growth restriction and platelet distribution width (PDW), platelet crit (PCT), mean platelet volume (MPV)? A Prospective Study

Year 2018, Volume: 10 Issue: 1, 51 - 56, 15.03.2018

Cemile Dayangan Sayan , Mahmut İlkin Yeral

https://doi.org/10.21601/ortadogutipdergisi.391962

Abstract

Aim: Intrauterine
growth restriction (IUGR) is still an important pregnancy complication bringing
on perinatal mortality and morbidity. Placental vascular dysfunction and
subsequent obliteration of placental 
blood vessels are mostly accepted etiopathological factors of
intrauterine growth restriction similar with preeclampsia. We aimed to
investigate the possible difference between pregnant women suffering from
intrauterine growth restriction and healty pregnant women for parameters of
platelet count, platelet crit, platelet distribution crit and mean platelet
volume.

Material and Methods:
This case- control study was conducted with 179 pregnant women. The study
population was consisted of  94 pregnant
women complicated with idiopathic  IUGR
(study group) and 85  healty pregnant
women  (control group). IUGR group was
divided in two subgroups according to umbilical artery doppler velocimetry
measurements. Complete blood count parameters including hemoglobin, platelet
count, platelet
distribution width (PDW),  platelet crit
(PCT), mean platelet volume (MPV) and white blood cell
count (WBC) were measured.

Results:
There was no significant difference between the groups for parameters of
hemoglobin, PC and PCT. The mean amniotic fluid index of IUGR group was
significantly lower than the control group (p=0.000). The mean WBC, MPV and PDW
levels of IUGR group were significantly higher than the control group (p=0.013,
p=0.047 and 0.035, respectively). The mean MPV level of IUGR group 1(umbilical artery S/D˃3)
was significantly higher than that of IUGR group 2 (umbilical artery S/D<3)
(p=0.045).

Conclusions: In the present study, we observed a significant difference
between IUGR and healty pregnant women for platelet parameters of MPV and PDW. Beside
this, we also observed higher MPV values in IUGR patients with increased
umblical artery resistance compared to that in IUGR patients with normal
umblical artery blood flow. Further studies are needed to discuss our results. 

Keywords

Intrauterine growth restriction, pregnancy, platelet

İntrauterin gelişme geriliği ile trombosit dağılım genişliği (PDW), platelet crit (PCT), ortalama trombosit hacmi (MPV) arasında bir ilişki var mı? Prospektif Bir Çalışma

Abstract

Amaç:
İntrauterin gelişme geriliği
(IUGR) günümüzde halen önemli bir gebelik komplikasyonu olup, perinatal
mortalite ve morbiditeye neden olur. Plasental vasküler disfonksiyon ve bunu
takiben plasental kan damarlarının obliterasyonu, preeklampsi ile benzer
şekilde çoğunlukla intrauterin büyüme kısıtlamasının etyopatolojik faktörleri
olarak kabul edilmektedir. Bu çalışmada intrauterin gelişme geriliği olan
gebeler ile sağlıklı gebeler arasında 
trombosit sayısı, trombosit kriteri, trombosit dağılım kriteri ve
ortalama trombosit hacmi parametreleri açısından olası farkın araştırılması
amaçlandı.

Gereç
ve Yöntemler: Bu vaka kontrol
çalışması 179 gebe ile yürütülmüştür. Çalışma popülasyonu, idiyopatik İUGR ile komplike
olan 94 gebe (çalışma grubu) ve 85 sağlıklı gebeden (kontrol grubu)
oluşmaktadır. IUGR grubu umbilikal arter doppler velosimetri ölçümlerine göre
iki alt gruba ayrıldı. Hemoglobin, trombosit sayısı, PDW, PCT, PC, MPV ve beyaz
küre sayısı (WBC) gibi tam kan sayımı parametreleri ölçüldü.

Bulgular: Hemoglobin, PC ve PCT parametreleri açısından gruplar
arasında anlamlı fark yoktu. IUGR grubunun ortalama amniotik sıvı indeksi kontrol
grubuna göre anlamlı derecede düşüktü (p = 0.000). IUGR grubunun ortalama WBC,
MPV ve PDW değerleri kontrol grubundan anlamlı derecede yüksekti (sırasıyla p =
0.013, p = 0.047 ve p= 0.035). IUGR 1. Grubunun (umbilikal arter S/D>3)
ortalama MPV düzeyi IUGR 2. Grubununkinden (umbilikal arter S/D<3) anlamlı
derecede yüksekti (p = 0.045).

Sonuçlar:
Bu çalışmada, MPV ve PDW değerleri açısından  İUGR olan gebeler ile  sağlıklı gebeler arasında anlamlı bir
farklılık olduğunu gözlemledik. Bunun yanında, normal umblikal arter kan
akımına sahip IUGR hastalarıyla karşılaştırıldığında, umblikal arter direncinde
artış bulunan IUGR hastalarında MPV değerleri daha yüksekti. Sonuçlarımız
tartışmak için yeni çalışmalara ihtiyaç bulunmaktadır.

Keywords

İntrauteringelişme geriliği, gebelik, platelet

References

• 1. Dikbas L, Yapca OE, Dikbas N, Gundogdu C.Paraoxonase-2 and paraoxonase-3: comparison of mRNA expressions in the placentae of unexplained intrauterine growth restricted and noncomplicated pregnancies. J Matern Fetal Neonatal Med. 2017;30(10):1200-6.
• 2. Restriction IG. ACOG Practice Bulletin No. 12. Washington, DC: American College of Obstetricians and Gynecologists; 2000.
• 3. Suhag A, Berghella V. Intrauterine growth restriction (IUGR): etiology and diagnosis. Curr Obstet Gynecol Rep 2013;2:102–11.
• 4. Sankaran S, Kyle PM. Aetiology and pathogenesis of IUGR. Best Pract Res Clin Obstet Gynaecol 2009;23:765–77.
• 5. Jackson SR, Carter JM. Platelet volume: laboratory measurement and clinical application. Blood reviews. 1993;7(2):104-13.
• 6. Boos CJ, Beevers GD, Lip GY. Assessment of platelet activation indices using the ADVIATM 120 amongst ‚high-risk’ patients with hypertension. Annals of medicine. 2007;39(1):72-8.
• 7. Akpinar I, Sayin MR, Gursoy YC et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. Journal of cardiology. 2014 ;63(2):112-8.
• 8. Ozturk ZA, Dag MS, Kuyumcu ME et al. Could platelet indices be new biomarkers for inflammatory bowel diseases? European review for medical and pharmacological sciences. 2013;17(3):334-41.
• 9. Marumoto Y, Kaibara M, Murata T. Hemorheological studies on platelet counts and size in normal pregnancy and pregnancies with preeclampsia and intrauterine growth retardation. Nihon Sanka Fujinka Gakkai Zasshi 1989;41:1380–6.
• 10. Freitas LG, Alpoim PN, Komatsuzaki F, et al. Preeclampsia: are platelet count and indices useful for its prognostic? Hematology2013;18:360–4.
• 11. Karateke A, Kurt RK, Baloğlu A. Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia. Ginekol Pol. 2015;86(5):372-5.
• 12. Ureyen I, Ozyuncu O, Sahin-Uysal N et al. Relationship of maternal mean platelet volume with fetal Doppler parameters and neonatal complications in pregnancies with and without intrauterine growth restriction. J Matern Fetal Neonatal Med. 2017 ;30(4):471-4.
• 13. Mandruzzato G, Antsaklis A, Botet F, et al. Intrauterine restriction (IUGR). J Perinat Med 2008;36:277–81.
• 14. Clausson B, Cnattingius S, Axelsson O. Outcomes of post-term births: the role of fetal growth restriction and malformations. Obstet Gynecol 1999;94:758–62.
• 15. Cunningham FG, Leveno KL, Bloom SL, et al. Fetal growth disorders. Williams obstetrics, Chapter 38. 22nd ed. New York: McGraw Hill; 2001:893–910.
• 16. Dundar O, Pektas MK, Bodur S, Bakır LV, Cetin A. Recurrent pregnancy loss is associated with increased red cell distribution width and platelet distribution width.J Obstet Gynaecol Res. 2015 ;41(4):551-8.
• 17. Yetkin E. Mean platelet volume not so far from being a routine diagnostic and prognosticmeasurement. Thrombosis and haemostasis. 2008;100(1):3-4.
• 18. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Current pharmaceutical design. 2011;17(1):47-5819. Vişan V, Anghelache-Lupaşcu I, Sălăvăscu T et al. Intrauterıne growth restrıctıon--predıctıve serum markers. Rev Med Chir Soc Med Nat Iasi. 2016 ;120(1):173-7.
• 20. Jagroop IA, Clatworthy I, Lewin J, Mikhailidis DP. Shape change in human platelets: measurementwith a channelyzer and visualisation by electron microscopy. Platelets. 2000;11(1):28-32.
• 21. Akingbola TS, Adewole IF, Adesina OA et al. Haematological profile of healthy pregnant women in Ibadan, southwestern Nigeria. Journal of Obstetrics and Gynaecology. 2006; 26:763–9.
• 22. Lurie S, Rigini N, Zabeeda D, Sadan O, Ezri T, Glezerman M. Changes in platelet function, volume and count during labor and 24 hours postpartum. Platelets. 2003;14:355–8.
• 23. Arlier S, Adiguzel C, Yilmaz ES et al. The role of mean platelet volume and platelet distribution width in the prediction of placental abruption. J Obstet Gynaecol. 2016 ;36(7):950-3.
• 24. Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med. 2017; 11:1-8.
• 25. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017 ;7:29-32.
• 26. Yılmaz ZV, Yılmaz E, Küçüközkan T. Red blood cell distribution width: A simple parameter in preeclampsia. Pregnancy Hypertens. 2016 ;6(4):285-7.