The role of platelet mass index in the prediction of preeclampsia full

Abstract

To assess the possible roles of platelet indices including platelet mass index (PMI), platelet count (PC), mean platelet volume (MPV) and PC/MPV in prediction of preeclampsia. 190 pregnant women diagnosed with preeclampsia and 100 healthy uncomplicated control patients were included in this retrospective study. Age, gestational week, fetal weight, alanine transaminase (ALT), aspartate transaminase (AST), creatinine, blood urea nitrogen (BUN), complete blood count parameters and platelet indices were compared. ROC curve was applied to analyze the cut-off values of the significantly differing parameters for prediction of preeclampsia. Preeclamptic patients gave birth significantly earlier than the controls. In preeclamptic patients, the mean values of PC, PC / MPV and PMI were significantly lower than the control group. Although mean MPV values were lower in preeclampsia patients, the difference was not significant. The cut-off values of PC, PC/MPV and PMI were found to be 207,500, 18448.16 and 2411.75 with a-sensitivity/specificity of 45.3%/ 44.3%, 42.2%/ 42.6% and 44.1%/ 44.3%, respectively. Indices such as PC, PC / MPV and PMI changed significantly in preeclampsia. Although they have low sensitivity and specificity, these indices can be combined with other parameters and used in the prediction of preeclampsia.

Keywords

• Mean Platelet Volume
• Platelet Indices
• Platelet Mass Index
• Preeclampsia

References

1. 1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):237-260
2. 2. Kumari A, Chakrawarty A, Singh A, Singh R. Maternofoetal complications and their association with proteinuria in a tertiary care hospital of a developing country. J Pregnancy 2014;2014:431-437
3. 3. Van Oostwaard MF, Langenveld J, Schuit E, et al. Recurrence of hypertensi ve disorders of pregnancy: an individual patient data metaanalysis. Am J Obstet Gynecol. 2015;212:1-17.
4. 4. Burton GJ, Charnock-Jones DS, Jauniaux E. Regulation of vascular growth and function in the human placenta. Reproduction. 2009;138(6):895–902.
5. 5. Juan P, Stefano G, Antonella S, Albana C. Platelets in pregnancy. J Prenat Med. 2011;5(4):90–92.
6. 6. Ozdemir S GH, Acar A, Celik C, et al. The Comprasion of Maternal and Fetal Outcomes Pregnancies of Complicated by Moderate to Severe Thrombocytopenia Caused by Gestational Thrombocytopenia Preeclampsia/ HELLP Syndrome and Immune Thrombocytopenic Purpura. Obstet Gynaecol Reprod Med. 2008;14:154-8.
7. 7. Tzur T, Sheiner E. Is there an association between platelet count during the first trimester and preeclampsia or other obstetric complications later in pregnancy? Hypertens Pregnancy. 2013;32(1):74–82.
8. 8. Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. J Clin Lab Anal. 2012;26(5):403–406.

9. 9. Yavuzcan A, Cağlar M, Ustün Y, et al. Mean platelet volume, neutrophillymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197–203.
10. 10. Eldor A, Avitzour M, Or R, Hanna R, Penchas S. Prediction of haemorrha¬gic diathesis in thrombocytopenia by mean platelet volume. Br Med J (Clin Res Ed) 1982;285(6339):397400.
11. 11. Gerday E, Baer VL, Lambert DK, et al. Testing platelet mass versus pla¬telet count to guide platelet transfusions in the neonatal intensive care unit. Transfusion 2009;49(10):2034-2039.
12. 12. Dundar O, Yoruk P, Tutuncu L, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008;28:1052-6.
13. 13. Han L, Liu X, Li H, et al. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PloS one. 2014;9:114488.
14. 14. Dogan K, Guraslan H, Senturk MB, et al. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy. 2015;34:434-42.
15. 15. Kanat-Pektas M, Yesildager U, Tuncer N, et al. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014;40:1840-5.
16. 16. Yoder SR, Thornburg LL, Bisognano JD. Hypertension in pregnancy and women of childbearing age. Am J Med. 2009;122:890-5.
17. 17. Ceyhan T, Beyan C, Ba¸ser I, et al. The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol 2006;85:320–22.
18. 18. Freitas LG, Alpoim PN, Komatsuzaki F, Carvalho Md, Dusse LM. Preeclampsia: are platelet count and indices useful for its prognostic? Hematology. 2013;18(6):360–364.
19. 19. Makuyana D, Mahomed K, Shukusho FD, Majoko F. Liver and kidney function tests in normal and pre-eclamptic gestation – a comparison with non-gestational reference values. Cent Afr J Med. 2002;48(5–6):55–59.
20. 20. Von Dadelszen P, Magee LA, Devarakonda RM, et al. The prediction of adverse maternal outcomes in preeclampsia. J Obstet Gynaecol Can 2004; 26:871–79.
21. 21. Zisk JL, Mackley A, Clearly G, Chang E, Christensen RD, Paul DA. Trans¬fusing neonates based on platelet count vs. platelet mass: a randomized fea¬sibility-pilot study. Platelets 2014;25(7):513-516.
22. 22. Yavuzcan Ozturk D, Ercin S, Gursoy T, Karatekin G, Ovali F. Platelet mass index: is it a hope for reduction of platelet transfusion in NICU? J Matern Fetal Neonatal Med 2016;29(12):1926-1929
23. 23. Korkmaz L, Baştuğ O, Ozdemir A, Korkut S, Karaca C, Akin MA, et al. The efficacy of propranolol in retinopathy of prematurity and its correlation with the platelet mass index. Curr Eye Res 2017;42:88e97.
24. 24. Demir N, Peker E, Ece İ, Ağelgin K, Bulan KA, Tuncer O. Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus? J Matern Fetal Neonatal Med 2016;29:1915e8.
25. 25. Zisk JL, Mackley A, Christensen RD, Paul DA. Is a small platelet mass associated with intraventricular hemorrhage in very low birth- weight infants? J Perinatol 2011;31:776e9.
26. 26. Gioia S, Piazze J, Anceschi MM, et al. Mean platelet volume: association with adverse neonatal outcome. Platelets 2007;18:284–8.
27. 27. Howarth S, Marshall LR, Barr AL, et al. Platelet indices during normal pregnancy and pre-eclampsia. Br J Biomed Sci 1999;56:20–2.