The use of platelet density and volume measurements to estimate the severity of pre‐eclampsia

Abstract

BACKGROUND: This study evaluated whether it is possible to estimate the severity of pre-eclampsia through in vitro measurements of platelet and granulocyte parameters. EXPERIMENTAL PROTOCOL: Eighteen pre-eclamptic women in the third-trimester of pregnancy and 11 women in the third-trimester of normal pregnancies were included in the study. Three to 12 months after delivery, 15 patients with pre-eclampsia and all the subjects with normal pregnancies were re-examined. Before delivery, peak platelet density was determined using a specially designed apparatus. Before and 3-12 months after delivery the following were measured: platelet counts, mean platelet volume and neutrophil and monocyte counts. Furthermore, circulating P-selectin, interleukin-6 and myeloperoxidase were determined to estimate platelet, monocyte and granulocyte activities, respectively. RESULTS: Compared to their results after delivery, pre-eclamptic females demonstrated lower platelet counts (P < 0.001) and raised mean platelet volumes (P < 0.01). Both pre-eclamptic women (P < 0.01) and normal pregnancies (P < 0.05) demonstrated elevated soluble P-selectin at pregnancy. Then pre-eclamptic women had advanced neutrophil counts (P < 0.01) but normal pregnancies showed a similar phenomenon (P < 0.001). Interleukin-6 remained normal during pregnancy. Plasma myeloperoxidase levels were lower both in pre-eclampsia (P < 0.05) and in normal pregnancies (P < 0.001). In pre-eclampsia elevated blood pressure was related to higher mean platelet volumes (P < 0.05). Furthermore, a group of pre-eclamptic females whose platelets had disturbed density distribution displayed elevated mean platelet volumes (P < 0.01). CONCLUSIONS: The present work demonstrates considerable platelet alterations in pre-eclampsia. We failed to show granulocyte involvement in the pathogenesis of the disease. Severe pre-eclampsia is related to elevated mean platelet volumes. The latter parameter is associated with disturbed density distribution. It appears possible to estimate disease severity from measurements of platelet density and volume.