Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter December 21, 2017

Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study

  • Cathy Monteith ORCID logo EMAIL logo , Karl Egan , Hugh O’Connor , Patricia Maguire , Barry Kevane , Paulina B. Szklanna , Sharon Cooley , Fergal Malone and Fionnuala Ní Áinle

Abstract

Objective:

To characterise Mean platelet volume (MPV) in patients with early onset preeclampsia (EOPE) and unaffected controls from time of first antenatal visit until the postpartum.

Materials and methods:

Retrospective secondary analysis of an observational study in an Irish tertiary referral centre with 9000 deliveries annually. The MPV of 27 women with EOPE was compared to 19 unaffected controls. The inclusion criteria for the disease state was the development of EOPE defined by the National Institute for Health and Care Excellence (NICE) guideline, as new onset hypertension presenting after 20 weeks and prior to 34 weeks with significant proteinuria. Between October 2013 and July 2015 we recruited 27 women with EOPE and 19 pregnant controls. Statistical analysis was performed using paired T-test of Mann-Whitney test where appropriate and a P-value <0.05 was deemed significant.

Results:

At time of diagnosis and late in the third trimester MPV was significantly increased to 9.0 (±0.3) fL in cases of EOPE in comparison to 8.5 (±0.6) fL in normotensive controls (P<0.05). There was no significant difference during the first trimester or postpartum when comparing the MPV in EOPE to controls.

Conclusion:

Despite an increased MPV at time of diagnosis of EOPE this study did not demonstrate a potential use for increased MPV as a first trimester screening tool.


Corresponding author: Dr. Cathy Monteith, Clinical Lecturer and Tutor, Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland, Tel.: 00353 14022520, Fax: 00353 14022543

Acknowledgement

This study received seed funding from the Rotunda Foundation, Dublin Ireland a registered charity (CHY20091). Following an external international peer review process the CAPE study received the prestigious Health research award of €327,000 (Grant identifier HRA POR-2013-377) to complete the study. The funders of this study were in no way involved in the writing process. We would like to thank our patients, medical colleagues, midwifery staff and laboratory technicians who provided assistance that greatly assisted the research.

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

  5. Disclosure of interest: The authors report no conflict of interest and full disclosure of interests are available to view online as supporting information.

  6. Contribution to authorship: We can confirm that all the authors have made substantive intellectual contributions to the paper; they understand their role in taking responsibility and being accountable for the publication. CM gathered the results, analysed the data and wrote the paper. KE analysed the data, performed statistical analysis and reviewed the paper. HOC recruited all patients, assisted with data collection and reviewed the paper. BK and PBS assisted in the management of the study and reviewed the paper. PM, SC, FM and FNA conceptualised the work and reviewed the paper.

References

[1] National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. 2010 (Clinical guideline [CG107]).Search in Google Scholar

[2] Organization WH. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. World Health Organization; 2011, p. 48.Search in Google Scholar

[3] Organization WH. Make every mother and child count, World Health Report, 2005. Geneva, Switzerland: World Health Organization; 2005.Search in Google Scholar

[4] Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk JJ, editors. SavingLives, Improving Mothers’ Care – Surveillance of maternal deaths in the UK 2011-13 and lessons learned toinform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13. National Perinatal Epidemiology Unit, University of Oxford 2015.: Oxford; 2015. p. 116.Search in Google Scholar

[5] Freitas LG, Alpoim PN, Komatsuzaki F, Carvalho MD, Dusse LMS. Preeclampsia: are platelet count and indices useful for its prognostic? Hematology 2013;18:359–63.10.1179/1607845413Y.0000000098Search in Google Scholar

[6] Piazze J, Gioia S, Maranghi L, Anceschi M. Mean platelet and red blood cell volume measurements to estimate the severity of hypertension in pregnancy. J Perinat Med. 2006;34:246–7.10.1515/JPM.2006.044Search in Google Scholar

[7] Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2014;175:107–11.10.1016/j.ejogrb.2013.12.036Search in Google Scholar

[8] Tygart S, Mcroyan D, Spinnato J, Mcroyan C, Kitay D. Longitudinal-study of platelet indexes during normal-pregnancy. Am J Obstet Gynecol. 1986;154:883–7.10.1016/0002-9378(86)90476-XSearch in Google Scholar

[9] Acikgoz N, Ermis N, Yagmur J, Cansel M, Atas H, Pekdemir H, et al. The evaluation of mean platelet volume levels in patients with idiopathic and ischemic cardiomyopathy: an observational study. Anadolu Kardiyol Derg. 2011;11:595–9.10.5152/akd.2011.161Search in Google Scholar PubMed

[10] Aydemir H, Piskin N, Akduman D, Kokturk F, Aktas E. Platelet and mean platelet volume kinetics in adult patients with sepsis. Platelets. 2015;26:331–5.10.3109/09537104.2012.701027Search in Google Scholar PubMed

[11] Ford H, Toomath R, Carter J, Delahunt J, Fagerstrom J. Mean platelet volume is increased in hyperthyroidism. Am J Hematol. 1988;27:190–3.10.1002/ajh.2830270308Search in Google Scholar PubMed

[12] Ulasli S, Ozyurek B, Yilmaz E, Ulubay G. Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. Pol Arch Med Wewn. 2012;122:284–90.10.20452/pamw.1284Search in Google Scholar PubMed

[13] Myatt L, Clifton RG, Roberts JM, Spong CY, Hauth JC, Varner MW, et al. First-trimester prediction of preeclampsia in nulliparous women at low risk. Obstet Gynecol. 2012;119:1234–42.10.1097/AOG.0b013e3182571669Search in Google Scholar PubMed PubMed Central

[14] Maconi M, Cardaropoli S, Cenci AM. Platelet parameters in healthy and pathological pregnancy. J Clin Lab Anal. 2012;26:41–4.10.1002/jcla.20502Search in Google Scholar PubMed PubMed Central

[15] Ulkumen BA, Pala HG, Calik E, Koltan SO. Platelet distribution width (PDW): a putative marker for threatened preterm labour. Pak J Med Sci. 2014;30:745–8.Search in Google Scholar

[16] Gezer C, Ekin A, Solmaz U, Taner CE, Tosun G, Ozeren M. The value of red cell distribution width for predicting subsequent preeclampsia. Cukurova Med J. 2016;41:224–8.10.17826/cutf.199198Search in Google Scholar

[17] Ahmed Y, Vaniddekinge B, Paul C, Sullivan MHF, Elder MG. Retrospective analysis of platelet numbers and volumes in normal-pregnancy and in preeclampsia. Br J Obstet Gynaecol. 1993;100:216–20.10.1111/j.1471-0528.1993.tb15233.xSearch in Google Scholar

[18] Akcan AB, Oygucu SE, Ozel D, Oygur N. Mean platelet volumes in babies of preeclamptic mothers. Blood Coagul Fibrinolysis. 2011;22:285–7.10.1097/MBC.0b013e3283451267Search in Google Scholar

[19] Aune B, Gjesdal K, Oian P. Late onset postpartum thrombocytosis in preeclampsia. Acta Obstet Gynecol Scand. 1999;78:866–70.Search in Google Scholar

[20] Braun KP, Gant NF, Olson CM, Parisi V, Forrest KA, Peterson CM. A discriminant function for preeclampsia: case-control study of minor hemoglobins, red cell enzymes, and clinical laboratory values. Am J Perinatol. 1997;14:297–302.10.1055/s-2007-994148Search in Google Scholar

[21] Calvert SM, Tuffnell DJ, Haley J. Poor predictive value of platelet count, mean platelet volume and serum urate in hypertension in pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;64:179–84.10.1016/0301-2115(95)02336-4Search in Google Scholar

[22] Han L, Liu XJ, Li HM, Zou JQ, Yang ZL, Han J, et al. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One. 2014;9:14.10.1371/journal.pone.0114488Search in Google Scholar

[23] Hutt R, Ogunniyi SO, Sullivan MHF, Elder MG. Increased platelet volume and aggregation precede the onset of preeclampsia. Obstet Gynecol. 1994;83:146–9.10.1016/0020-7292(94)90489-8Search in Google Scholar

[24] Moraes D, Munhoz TP, da Costa BEP, Hentschke MR, Sontag F, Lucas LS, et al. Immature platelet fraction in hypertensive pregnancy. Platelets. 2016;27:333–7.10.3109/09537104.2015.1101060Search in Google Scholar PubMed

[25] Oruç Koltan S, Artunç Ülkümen B, HG. P. The relation ofmean platelet volume and platelet distribution width levels with the severity of preeclampsia. Perinat J. 2016;24:162–5.10.2399/prn.16.0243009Search in Google Scholar

[26] Yavuzcan A, Caglar M, Ustun Y, Dilbaz S, Ozdemir I, Yildiz E, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85:202–8.10.17772/gp/1713Search in Google Scholar

[27] Saleh AA, Bottoms SF, Farag AM, Dombrowski MP, Welch RA, Norman G, et al. Markers for endothelial injury, clotting and platelet activation in preeclampsia. Arch Gynecol Obstet. 1992;251:105–10.10.1007/BF02718370Search in Google Scholar PubMed

[28] Karalis I, Nadar SK, Yemeni EA, Blann AD, Lip GYH. Platelet activation in pregnancy-induced hypertension. Thromb Res. 2005;116:377–83.10.1016/j.thromres.2005.01.009Search in Google Scholar PubMed

[29] Ohshige A, Yoshimura T, Matsui K, Koyama H, Ito M, Okamura H. Reduced platelet-activating factor-acetylhydrolase activity in maternal plasma obtained from normotensive pregnant women destined develop pregnancy-induced hypertension. Hypertens Pregnancy. 1998;17:297–306.10.3109/10641959809009603Search in Google Scholar

[30] Jaremo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30:1113–8.10.1046/j.1365-2362.2000.00753.xSearch in Google Scholar PubMed

[31] Dogan K, Guraslan H, Senturk MB, Helvacioglu C, Idil S, Ekin M. Can platelet count and platelet indices predict the risk and the prognosis of preeclampsia? Hypertens Pregnancy. 2015;34:434–42.10.3109/10641955.2015.1060244Search in Google Scholar PubMed

[32] Altinbas S, Togrul C, Orhan A, Yucel M, Danisman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. J Clin Lab Anal. 2012;26:403–6.10.1002/jcla.21542Search in Google Scholar PubMed PubMed Central

[33] Özdemirci Ş, Başer E, Kasapoğlu T, Karahanoğlu E, Kahyaoglu I, Yalvaç S, et al. Predictivity of mean platelet volume in severe preeclamptic women. Hypertens Pregnancy. 2016;35:474–82.10.1080/10641955.2016.1185113Search in Google Scholar PubMed

[34] Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374:13–22.10.1056/NEJMoa1414838Search in Google Scholar PubMed

Received: 2017-06-08
Accepted: 2017-11-07
Published Online: 2017-12-21
Published in Print: 2018-11-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 27.4.2024 from https://www.degruyter.com/document/doi/10.1515/jpm-2017-0188/html
Scroll to top button