Use of platelet count as the first line screening test to detect coagulation disorder in pre-eclamptic and eclamptic patients

Abstract

Background: Preeclampsia and eclampsia are appropriate diseases to screen, as it is common, important, and assossiated with increase maternal and perinatal mortality. Objective: To determine the relationship between platelet count and adverse maternal outcomes and to determine the accuracy of platelet count to predict coagulation disorders in patients of pre-eclampsia and eclampsia. Methods and Materials :This was a cross sectional observational study and conducted from 1st march 2013 to 30th august 2013 in the Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh. Total 128 samples were taken from indoor of Institute of Child and Mother Health, Matuail, Dhaka. Purposive sampling technique was followed in this study. Result: Among 128 patients of eclampsia and pre-eclampsia, average mean maternal age for the eclampsia group was 23.12±4.20 years and mean maternal age for the pre-eclampsia group was 28.24±5.86 years.  Platelet count  > 200,000 / cu mm was present in 6 (4.68 % ) eclampsia and PET cases , out of which no patient developed any abnormal coagulation or any complications. Platelet count between 150,000 – 200,000 / cu mm  was present in 25 ( 19.53 % ) eclampsia and PET cases , out of which no patient shows any abnormal coagulation but  6 ( 4.69 % ) cases shows adverse maternal outcome like PPH , pulmonary edema, acute renal failure, HELLP syndrome  and 3 (2.34 %) patients need blood transfusion . Platelet count between 100,000 -150,000 / cu mm was  present in 96 ( 75% ) eclampsia and PET cases , out of which 4 ( 3.12 % ) developed abnormal coagulation and 23 ( 17. 96 % ) cases shows adverse maternal outcome (discussed above ) and 16  ( 12.5 % ) cases needs blood transfusion . Conclusion: It is recommended that platelet count can be used as a screening test for early detection of generalized coagulopathy in women with pre-eclampsia and eclampsia. A platelet count < 100 × 109/L should alert caregivers to the real possibility of generalized coagulopathy.