Role of platelet indices in prediction of preeclampsia.

OBJECTIVES: To compare platelet indices in preeclamptic and normotensive pregnants and to investigate the clinical use of these parameters in preeclampsia prediction. MATERIAL AND METHODS: This retrospective case- control study included 257 preeclampsia patients and 264 healthy pregnant women as the control group. The groups were compared in terms of platelet count (PC), mean platelet volume (MPV), platelet distribution range (PDW), plateletcrit (Pct), Pct / MPV ratio and PC / MPV ratio. RESULTS: Between the preeclampsia group and the control group; mean platelet count (227.22 ± 78.58 vs 236.69 ± 64.30), plateletcrit (PCT) (0.21 ± 0.06 vs 0.24 ± 0.27), and platelet distribution width (PDW) (17.11 ± 0.80 vs 17.29 ± 0.82) were not significantly different (p> 0.05). However, MPV values were significantly higher in the preclampsia group compared to the control group (9.66 ± 1.62 and 8.92 ± 1.33, respectively) (p < 0.001). In our study, the optimum cut-off value of MPV was 9.15 with 58.7% sensitivity and 61.7% specificity for the prediction of preeclampsia. Pct/MPV ratio (0.02 ± 0.007 vs 0.027 ± 0.029) ( p = 0.01) and PC/MPV ratio ( 24.63 ± 10.90 vs 27.63 ± 10.24) (p = 0.001) were significantly lower in the preeclampsia group than in the control group. CONSLUSIONS: In preeclampsia, changes in platelet functions, destruction and production lead to changes in platelet indices. Compared with normal healthy pregnant women, preeclamptic pregnant women have higher MPV values. In preeclampsia prediction, MPV and PC/MPV ratio are promising as a diagnostic parameter.

Comparison of serum human pregnancy-specific beta-1-glycoprotein 1 levels in pregnant women with or without preeclampsia.

The aim of this study was to investigate the relationship between the maternal serum levels of pregnancy-specific beta-1-glycoprotein 1 (PSG1) and preeclampsia, and to compare levels of PSG1 in pregnancies with preeclampsia and uneventful pregnancies. A case-control study was conducted in a research and training hospital. A total of 40 women with preeclampsia and 42 healthy pregnant women who were gestational age-matched were included. Serum PSG1 levels were measured using enzyme-linked immunosorbent assay. The maternal serum PSG1 levels were significantly lower in patients with preeclampsia compared with controls (11.60 ± 8.08 vs. 17.58 ± 9.72 ng/mL, p = .003). Circulating PSG1 levels were negatively correlated with age in the preeclampsia and control groups (r = -0.322, p = .043), (r = -0.430, p = .005). PSG1 levels, age, blood urea nitrogen levels and birth weight were significantly associated with high odds of having preeclampsia. Receiver operating characteristic (ROC) curve analysis confirmed that the area under ROC curve was 0.707 (95% CI: [0.595-0.819], p < .001) for PSG1. The optimal cut-off value of PSG1 for detecting preeclampsia was ≤ 11.80 ng/mL. There may be a decrease in PSG1 production in preeclampsia-complicated pregnancies where there are pathologies related to placenta formation. A decline in PSG1 concentrations may reflect placental dysfunction.Impact StatementWhat is already known on this subject? Previous studies have reported abnormal pregnancy-specific glycoprotein (PSG) levels in complicated pregnancies and demonstrated their importance in maintaining a healthy pregnancy. Human PSG homologues have been identified in species with haemochorial placentation such as non-human primates, rats and mice, where foetal cells are in direct contact with the maternal circulation. There are studies in which there is no clear relationship between PSGs and preeclampsia.What the results of this study add? We have demonstrated that circulating PSG1 levels were significantly lower in women with preeclampsia than in healthy pregnant women. There may be a decrease in PSG1 production in preeclampsia-complicated pregnancies where there are pathologies related to placenta formation and function. The results obtained from this current study could be used to clarify the relationship between PSG1 levels and preeclampsia.What the implications are for clinical practice and/or further research? Evaluation of the role of circulating PSG1 levels in preeclampsia would be helpful in order to design further studies to determine the feasibility of using PSG1 as a serum marker to predict the risk of developing preeclampsia. The screening performance of PSG1 for preeclampsia is not yet clinically relevant, but may become so when evaluated together with other placental proteins. This will give a lead to further researches which could focus on the early detection of preeclampsia with the combination of several serum markers.