Early detection of preeclampsia by determination of platelet aggregability

Preeclampsia is still a leading cause of maternal and fetal morbidity and m ortality. There is evidence for the involvement of platelets. Therefore, we investigated the suitability of corrected whole blood impedance aggregomet ry as an early predictor of preeclampsia in 71 consecutive, high-risk pregn ancies. According to the occurrence of preeclampsia, defined postpartum by an independent investigator, and the stage of pregnancy (early and late, cu toff: 25 weeks of gestation), four study groups were defined. Platelet aggr egation data were corrected for the influence of hematocrit and platelet co unt by a special purpose software package. Women developing preeclampsia sh owed significantly higher platelet aggregation response compared to control s in early and late pregnancy. In early pregnancy, all women developing pre eclampsia had aggregation responses to collagen higher than the highest res ponses among the controls. Hence: this test had a 100% positive predictive value of subsequent preeclampsia. Despite being significantly increased, pl atelet aggregability was of minor predictive value in late pregnancy. We co nclude that preeclampsia is accompanied by exaggerated platelet aggregabili ty, particularly perceptible early in the course of pregnancy. We propose c ollagen-induced whole blood platelet aggregation with correction for the in fluence of hematocrit and platelet count for early detection of preeclampsi a. (C) 2000 Elsevier Science Ltd. All rights reserved.