Association between haemostatic parameters at diagnosis and pregnancy outcome in women with pre-eclampsia in south-east Nigeria

Abstract

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 from 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 and 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 11(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 existence of thrombocytopenia and derangement in PT and APTT is  common in preeclampsia. The prevalence of feto-maternal complications is high in preeclampsia. However, the coagulation derangement showed no   associations with these complications and likely not predictors of poor pregnancy outcome.