Changes in Blood Coagulation Parameters and Platelet Indices in Pregnancies with Gestational Hypertension and Preeclampsia


Author(s):

Alina-Georgiana Corduneanu¹,², Ioana Păvăleanu³, Renáta Gerculy¹,⁴, Mihai Emil Căpîlna¹,⁵

Affiliation:

¹ “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
² “Elena Doamna” Clinical Hospital of Obstetric and Gynecology, Iași, Romania
³ Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
⁴ Clinic of Cardiology, Emergency Clinical County Hospital, Târgu Mureș, Romania
⁵ First Obstetrics and Gynecology Clinic, Emergency Clinical County Hospital, Târgu Mureş, Romania

DOI: 10.2478/jim-2023-0014

ABSTRACT
Background: Hypertensive disorders of pregnancy impact approximately 10% of pregnancies worldwide. During pregnancy, there are changes in the expression of coagulation and fibrinolytic proteins that promote clot formation. While a normal pregnancy is associated with increased coagulation, women with preeclampsia experience even greater coagulation. Aim of the study: To assess the potential of blood coagulation parameters and platelet indices as predictors for preeclampsia. Material and Methods: The study included 97 age-matched pregnant women, 78 of which had gestational hypertension and 19 had preeclampsia and its severe forms. The study compared demographic data, clinical characteristics, blood clotting parameters and platelet measurements of all participants. Results: Patients with preeclampsia had slightly elevated coagulation parameters such as activated partial thromboplastin time, prothrombin time activity percentage, and prothrombin time. We found a statistically significant difference in prothrombin time activity percentage (106.6 ± 3.457; 95.07 ± 2.165, p = 0.0166). However, patients with preeclampsia had significantly lower levels of international normalized ratio (0.975 vs. 1.048, p = 0.019), fibrinogen (314.2 mg/dL vs. 344.5 mg/dL, p = 0.0247), and platelet count (234.2 ± 19.59 × 104/μL vs. 280.8 ± 8.63 × 104/μL, p = 0.0214) than women with gestational hypertension. We found no statistically significant differences between the groups regarding mean platelet volume and platelet distribution width. Conclusions: Platelet count is a promising method for diagnosing preeclampsia due to its simplicity. Mean platelet volume, activated partial thromboplastin time, and prothrombin time increased in women with preeclampsia, indicating a hypercoagulable state in the third trimester in these patients. Prothrombin time activity percentage increased significantly and could be a potentially parameter in predincting preeclampsia.