Association between haemostatic parameters at diagnosis and pregnancy outcome in women with pre-eclampsiain south-east Nigeria
Keywords:
Preeclampsi, maternal outcome, fetal outcome, thrombocytopenia, prothrombin time, activated partial thromboplastin time, coagulation screening testsAbstract
Background Pre-eclampsia complicates 3-5% of pregnancies and is a global cause of perinatal and maternal death. In pre-eclampsia, activated maternal inflammatory response and immune dysfunction culminate in serious derangement in the coagulation and fibrinolytic systems. we aimed to determine if changes in the coagulation system predict severity and outcome of preeclampsia.
Methodology: This was a prospective self-controlled study of pre-eclamptic pregnant women recruited at 28 weeks and followed till delivery. At the point of diagnosis, blood sample for platelet count, prothrombin time and activated partial thromboplastin time was collected. Data was analyzed using IBM SPSS version 20. P value was set at <0.05.
Results: Thirty women with preeclampsia were followed up to delivery in this study. Their mean gestational ages were 33.87± 3.93 and 37.50±2.77 weeks at recruitment and delivery respectively. Of the complications seen in these women, maternal death 16(36.7%) was the most frequent maternal complication while prematurity 23 (76.7%) was the most frequent fetal complication. Ten (33.3%) subjects had thrombocytopenia, 7(23.3%) had isolated prolonged PT, 17(56.7%) had isolated prolonged APTT while 18(60.0%) had both prolonged PT and APTT. Maternal and fetal complications had no significant association with the PT and APTT of the study subjects.
Conclusion: The prevalence rates of thrombocytopenia and derangement in PT and APTT are 10%, 56.7% and 60% respectively in preeclampsia. The prevalence of fetomaternal complications is high in preeclampsia. However, the coagulation derangement showed no associations with these complications and may not serve as predictors of poor pregnancy outcome.
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