Low Platelet Count Analysis as a Prognostic Indicator in Pregnancy-induced Hypertension

Abstract

Introduction: Hypertension is one of the serious complications of pregnancy which virtually affects all maternal organs such as the liver, kidney, brain, and placenta. Changes in the hemostatic system are observed in normal and hypertensive patients. The frequency and intensity of maternal thrombocytopenia vary and are dependent on the intensity of the disease process and duration of pregnancy-induced hypertension (PIH) syndrome. In general, the lower the platelet counts, the higher the maternal and fetal morbidity and mortality. Aims and Objectives: The aims and objectives of the study were to study the platelet counts in cases of PIH, compare the values with normotensive pregnant participants, and study the association between thrombocytopenia and fetomaternal outcome. Materials and Methods: A total of 226 patients were included in the study and were evaluated for their platelet count and fetomaternal outcome. The patients were divided into two groups, with each group comprising 113 patients, namely, Group I which included controls and Group II which included patients with PIH (subgroups: gestational hypertension, preeclampsia, and eclampsia). Platelet counts in all groups were charted, compared, and correlated with various maternal parameters such as age, gravidity, severity of hypertension, gestational age of termination, maternal complications, and hospital stay. Fetal parameters studied were intrauterine growth restriction, stillbirth, neonatal intensive care unit care, and intrauterine fetal demise. Results: Our study found that the mean platelet count decreases with the severity of gestational hypertension. Thus, the highest platelet count was seen in the control group (D), i.e., 1.67 lakh/mm3 and the lowest platelet count was seen in the eclamptic group, (C) i.e., 0.75 lakh/mm3. Pregnancies complicated by thrombocytopenia were terminated at an earlier gestation (35–37 weeks). Maternal complications such as postpartum hemorrhage (56.5%) and stitch line ooze (27.5%) were found to occur more in the thrombocytopenic group. The association between birth weight and thrombocytopenia was statistically significant in our study. Conclusion: Thrombocytopenia associated with PIH is a reliable prognostic indicator for the severity of hypertension as well as the associated maternal and fetal morbidity.