P. Jaremo et al., The use of platelet density and volume measurements to estimate the severity of pre-eclampsia, EUR J CL IN, 30(12), 2000, pp. 1113-1118
Citations number
15
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research General Topics
Background This study evaluated whether it is possible to estimate the seve
rity of pre-eclampsia through in vitro measurements of platelet and granulo
cyte parameters.
Experimental protocol Eighteen pre-eclamptic women in the third-trimester o
f pregnancy and 11 women in the third-trimester of normal pregnancies were
included in the study. Three to 12 months after delivery, 15 patients with
pre-eclampsia and all the subjects with normal pregnancies were re-examined
. Before delivery, peak platelet density was determined using a specially d
esigned apparatus. Before and 3-12 months after delivery the following were
measured: platelet counts, mean platelet volume and neutrophil and monocyt
e counts. Furthermore, circulating P-selectin, interleukin-6 and myeloperox
idase were determined to estimate platelet, monocyte and granulocyte activi
ties, respectively.
Results Compared to their results after delivery, pre-eclamptic females dem
onstrated lower platelet counts (P < 0.001) and raised mean platelet volume
s (P < 0.01). Both pre-eclamptic women (P < 0.01) and normal pregnancies (P
< 0.05) demonstrated elevated soluble P-selectin at pregnancy. Then pre-ec
lamptic women had advanced neutrophil counts (P < 0.01) but normal pregnanc
ies showed a similar phenomenon (P < 0.001). Interleukin-6 remained normal
during pregnancy. Plasma myeloperoxidase levels were lower both in pre-ecla
mpsia (P < 0.05) and in normal pregnancies (P < 0.001). In pre-eclampsia el
evated blood pressure was related to higher mean platelet volumes (P < 0.05
). Furthermore, a group of pre-eclamptic females whose platelets had distur
bed density distribution displayed elevated mean platelet volumes (P < 0.01
).
Conclusions The present work demonstrates considerable platelet alterations
in pre-eclampsia. We failed to show granulocyte involvement in the pathoge
nesis of the disease. Severe pre-eclampsia is related to elevated mean plat
elet volumes. The latter parameter is associated with disturbed density dis
tribution. It appears possible to estimate disease severity from measuremen
ts of platelet density and volume.