Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia

Autoři: Feven Tesfay aff001;  Mikias Negash aff002;  Jemal Alemu aff002;  Mohammedtahir Yahya aff003;  Gebre Teklu aff001;  Meseret Yibrah aff001;  Tsegay Asfaw aff001;  Aster Tsegaye aff002
Působiště autorů: Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia aff001;  Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia aff002;  Department of Gynecology and obstetrics, College of Health Science, Mekelle University, Mekelle, Ethiopia aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225536



Platelet parameters alterations are one of the most commonly identified hematological changes in preeclampsia (PE). However, their functions as a tool for prediction and prognosis of PE have not been extensively studied in developing countries. The aim of this study was to compare platelet count (PC), and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) between preeclamptic and normotensive (NT) pregnant women and assess their role in diagnosis and prediction of PE development.


A cross sectional comparative study was conducted at Ayder comprehensive specialized hospital (ACSH) and Mekelle general hospital (MGH) from January to March 2017. Platelet parameters of mild preeclamptic (mPE) (n = 35), severe preeclamptic (sPE) (n = 44) and NT pregnant women (n = 140) were analyzed using SYSMEX-XT 4000i automated hematology analyzer. One-way ANOVA supplemented with post-hoc test, receiver operating characteristics (ROC) curve and pearson correlation test statistical analyses were performed. P < 0.05 was considered significant.


Pregnant women with sPE had lower PC as compared with that of mPE and NT women (p<0.05). All platelet indices showed significant increment with severity of PE. PC was negatively correlated with platelet indices. There was a positive correlation among platelet indices. ROC analysis revealed that MPV had the largest area under the ROC curve (0.85; 95%CI (0.79, 0.89)) with cutoff value >9.45fl, sensitivity of 83.5%, specificity of 86.4%, positive predictive value of 77.6% and negative predictive value of 90.3%.


MPV and PC were identified as good candidates for sPE diagnosis. Because evaluation of platelet parameters is rapid, reliable and economical, they can be utilized as an alternative biomarker for prediction and prognosis of PE.

Klíčová slova:

Blood counts – Bone marrow – Ethiopia – Hematology – Platelets – Preeclampsia – Pregnancy – Prognosis


1. Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Med. 2016;26(2):178–93.

2. Lopez E, Bermejo N, Berna-Erro A, Alonso N, Salido GM, Redondo PC, et al. Relationship between calcium mobilization and platelet α-and δ-granule secretion. A role for TRPC6 in thrombin-evoked δ-granule exocytosis. Arch Biochem Biophys. 2015;585:75–81. doi: 10.1016/ 26386308

3. Golebiewska EM, Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 2015;29(3):153–62. doi: 10.1016/j.blre.2014.10.003 25468720

4. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol. 2005;128(5):698–702. doi: 10.1111/j.1365-2141.2004.05357.x 15725092

5. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365(9461):785–99. doi: 10.1016/S0140-6736(05)17987-2 15733721

6. Stekkinger E, Zandstra M, Peeters LL, Spaandernen ME. Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome. Obstet Gynaecol. 2009; 114(5): 1076–1084.

7. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look P. WHO analysis of causes of maternal death: a systemic review. Lancet. 2006; 367(9516):1066–1074. doi: 10.1016/S0140-6736(06)68397-9 16581405

8. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009; 33(3): 130–137. doi: 10.1053/j.semperi.2009.02.010 19464502

9. Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011;2011, Article ID 481095, 6 pages, 2011.

10. Staff AC, Benton SJ, von Dadelszen P, Roberts JM, Taylor RN, Powers RW, et al. Redefining Preeclampsia using placenta-derived biomarkers. Hypertension. 2013; 61(5): 932–942. doi: 10.1161/HYPERTENSIONAHA.111.00250 23460278

11. Vinodhini R and Lavanya K. Evaluation of platelet count as a prognostic index in eclampsia and pre-eclampsia. Int J Modn Res Revs. 2014;2(10):447–452.

12. AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag. 2016; 12: 477–480 doi: 10.2147/VHRM.S120944 27920548

13. Nooh AM, Abdeldayem HM. Changes in platelet indices during pregnancy as potential markers for prediction of preeclampsia development. Open J Obstet Gynecol. 2015;5(12):703–712.

14. Semenovakaya Z, Erogul M. Pregnancy, Preeclampsia. eMedicine–Medical Reference. 2010; 28:1349–1355.

15. Townsley DM. Hematologic complications of pregnancy. InSeminars in hematology 2013 Jul 1 (Vol. 50, No. 3, pp. 222–231). WB Saunders.

16. Fatemeh T, Marziyeh G, Nayereh G, Anahita G, Samira T. Maternal and perinatal outcome in nulliparious women complicated with pregnancy hypertension. J Pak Med Assoc. 2010;60(9):707–710. 21381572

17. Abass AE, Abdalla R, Omer I, Ahmed S, Khalid A, Elzein H. Evaluation of platelets count and indices in pre-eclampsia compared to normal pregnancies. IOSR J Dent Med Sci. 2016;1(15):5–8.

18. Neiger R, Contag SA, Coustan DR. Preeclampsia effect on platelet count. Am J Perinatol. 1992;9(05/06):378–80.

19. Sultana R, Karim SF, Atia F, Ferdousi S, Ahmed S. Platelet count in Preeclampsia. J Dhaka National Med College Hospital. 2012;18(2):24–6.

20. Amita K, Kumar HN, Shobha SN, Shankar V. The role of platelet parameters as a biomarker in the diagnosis and in predicting the severity of preeclampsia. Indian J Pathol Oncol. 2015;2(2):57–60.

21. Dadhich S, Agrawal S, Soni M, Choudhary R, Jain R, Sharma S, et al. Predictive value of platelet indices in development of preeclampsia. J SAFOG. 2012;4(1):17–21.

22. Freitas LG, AFreitas LG, Alpoim PN, Komatsuzaki F, Carvalho MD, Dusse LM. Preeclampsia: are platelet count and indices useful for its prognostic?. Hematol. 2013;18(6):360–364.

23. Alkholy EA, Farag EA, Behery MA, Ibrahim MM. The significance of platelet count, mean platelet volume and platelet width distribution in preeclampsia. AAMJ. 2013;11(1):205–206.

24. Santos EV, Meirelles Filho J. Measurement of platelet parameters in normal and preeclamptic pregnant women. Rev Bras Ginecol Obstet. 2004;26(3):201–206.

25. Kulkarini RD, Sutaria UD. Platelet counts in toxaemia of pregnancy. Ind J Obstet Gynecol. 1983; 33(7): 321–325

26. Howarth S, Marshall LR, Barr AL, Evans S. Platelet indices during normal pregnancy and pre-eclampsia. Br J Biomed Sci. 1999;56(1):20–22. 10492911

27. Hutt R, Ogunniyi SO, Sullivan MH, Elder MG. Increased platelet volume and aggregation precede the onset of preeclampsia. Gynecol Obstet. 1994;83(1):146–149.

28. Ceyhan T, Beyan C, Başer İ, Kaptan K, Güngör S, Ifran A. The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol. 2006;85(5):320–322. doi: 10.1007/s00277-006-0091-7 16518600

29. Song YH, Park SH, Kim JE, Ahn JY, Seo YH, Park PH, et al. Evaluation of platelet indices for differential diagnosis of thrombocytosis by ADVIA 120. Korean J Lab Med. 2009;29(6):505–509. doi: 10.3343/kjlm.2009.29.6.505 20046080

30. Ahmed W, Ammar EK, Moharam Abd, Abd EH, Gehad MH, Mohamed MI. Evaluation of platelet indices and their significance in Preeclampsia. Nat Sci. 2014;12(3):147–153.

31. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28–32. 20411056

32. Sitotaw C, Asrie F, Melku M. Evaluation of platelet and white cell parameters among pregnant women with Preeclampsia in Gondar, Northwest Ethiopia: A comparative cross-sectional study. Pregnancy Hypertension. 2018; 13:242–247. doi: 10.1016/j.preghy.2018.06.006 30177059

33. Birhaneselassie M, Birhanu A, Gebremedhin A, Tsegaye A. How useful are complete blood count and reticulocyte reports to clinicians in Addis Ababa hospitals, Ethiopia?. BMC Hematol. 2013 Dec;13(1):11. 24325971

34. Negash M, Tsegaye A, Gebremedhin A. Diagnostic predictive value of platelet indices for discriminating hypo productive versus immune thrombocytopenia purpura in patients attending a tertiary care teaching hospital in Addis Ababa, Ethiopia. BMC Hematol. 2016 Dec;16(1):18.

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2019 Číslo 11