Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia.

Background: Platelet parameters alterations are one of the most commonly identified hematological changes in preeclampsia (PE). However, their functions as a tool for prediction and prognosis of PE have not been extensively studied in developing countries. The aim of this study was to compare platelet count (PC), and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) between preeclamptic and normotensive (NT) pregnant women and assess their role in diagnosis and prediction of PE development.

Methods: A cross sectional comparative study was conducted at Ayder comprehensive specialized hospital (ACSH) and Mekelle general hospital (MGH) from January to March 2017. Platelet parameters of mild preeclamptic (mPE) (n = 35), severe preeclamptic (sPE) (n = 44) and NT pregnant women (n = 140) were analyzed using SYSMEX-XT 4000i automated hematology analyzer. One-way ANOVA supplemented with post-hoc test, receiver operating characteristics (ROC) curve and pearson correlation test statistical analyses were performed. P < 0.05 was considered significant.

Result: Pregnant women with sPE had lower PC as compared with that of mPE and NT women (p<0.05). All platelet indices showed significant increment with severity of PE. PC was negatively correlated with platelet indices. There was a positive correlation among platelet indices. ROC analysis revealed that MPV had the largest area under the ROC curve (0.85; 95%CI (0.79, 0.89)) with cutoff value >9.45fl, sensitivity of 83.5%, specificity of 86.4%, positive predictive value of 77.6% and negative predictive value of 90.3%.

Conclusion: MPV and PC were identified as good candidates for sPE diagnosis. Because evaluation of platelet parameters is rapid, reliable and economical, they can be utilized as an alternative biomarker for prediction and prognosis of PE.