Scholarly Article
PLATELET INDICES AS PROGNOSTIC MARKERS ACROSS THE SPECTRUM OF PREGNANCY-INDUCED HYPERTENSION: A PROSPECTIVE COMPARATIVE STUDY
Kalpande , Manoj Shamrao, Gyanendra Singh Bhadauria, Malik Ajay, Singh Swarnima, Parwate Sameer
2026-09-11 · International Journal of Clinical and Biomedical Research · Sumathi Publications
Abstract
ABSTRACT Background: Pregnancy-induced hypertension (PIH) complicates 6-10% of pregnancies and remains a leading cause of maternal and perinatal morbidity. Platelet activation is central to its pathophysiology through endothelial injury and consumptive coagulopathy. Mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (PLCR) are morphometric indices generated automatically during a routine complete blood count at no additional cost. This study evaluated their behaviour across the PIH severity spectrum. Methods: A prospective comparative study was conducted at a tertiary Armed Forces hospital in New Delhi between May 2016 and May 2018. Seventy-three women with PIH (gestational hypertension n = 29, preeclampsia n = 37, eclampsia n = 7) and 70 normotensive pregnant women beyond 20 weeks of gestation were enrolled (N = 143). Platelet count, MPV, PDW and P-LCR were measured on a Sysmex KX-21 analyser, with platelet counts independently verified on Leishman-stained smears by two pathologists blinded to clinical details. Between-group comparisons used the Mann-Whitney U test. Results: Mean platelet count was lower in PIH than in controls (155.3 ± 88.5 versus 222.0 ± 73.2 × 10³/µL; p < 0.001). All three indices were higher in every PIH subgroup (p <0.001 for each): MPV 11.90 ± 1.61 versus 10.30 ± 1.57 fL, PDW 17.67 ± 3.89 versus 14.26 ± 3.26 fL, and P-LCR 40.21 ±9.82% versus 29.02 ± 10.49%. Values rose stepwise with severity, peaking in eclampsia (MPV 12.91 fL, PDW 21.01 fL, PLCR 47.74%). In gestational hypertension the platelet count did not differ from controls (p = 0.372) although all threeindices were already elevated (p < 0.001). Using the laboratory reference limits, P-LCR exceeded its threshold in 89.0% of PIH cases and PDW in 86.3%, against 48.6% for MPV. Conclusion: MPV, PDW and P-LCR rise in graded fashion across the PIH spectrum and are elevated in gestational hypertension at a stage when the platelet count is still normal, identifying a window of subclinical platelet activation that the count alone does not reveal. Because these indices are byproducts of a test already performed antenatally, they are attractive adjuncts to risk stratification. Their diagnostic performance cannot be judged from this study, however, since specificity was not assessed and the reference limits applied were not derived from a pregnant population; threshold derivation in pregnancy with formal receiver operating characteristic analysis is the necessary next step.
Keywords
eclampsia, mean platelet volume, platelet distribution width, platelet-large cell ratio, pregnancy-induced hypertension, preeclampsia
Citation Details
International Journal of Clinical and Biomedical Research, Vol. 11, No. 3, pp. 365-372