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Feb 20, 2017Keywords:
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Determination of coagulopathy complicating severe preeclampsia and eclampsia with platelet count in a University Hospital, South‑South, Nigeria
Abstract
Background: Pre‑eclampsia is a multisystemic disorder complicating pregnancy. It is associated with a significant burden on maternal and perinatal health, especially when complicated by coagulation abnormalities.
Objective: The objective of the study was to determine the level of thrombocytopenia that predicts a risk of abnormalities of coagulation indices in severe preeclampsia and eclampsia.
Materials and Methods: Haemostatic factors including platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT) and plasma fibrinogen were done for a cohort of 90 patients with severe preeclampsia and eclampsia at the Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City. Their demographic and laboratory data were analysed using the Statistical Package for Social Sciences version 20.0 and GraphPad InStat 3 software.
Results: Twenty‑one (23.3%) of the 90 patients had eclampsia. Mean age was 29.78 ± 4.7 years, parity was 2.54 ± 1.6 and gestational age was 36.14 ± 2.9 weeks. Thrombocytopenia was found in 13 (14.4%) patients, whereas biochemical coagulopathy was found in 6 (6.7%) patients. Thrombocytopenia was 43% more likely with eclampsia than severe preeclampsia (47.6% vs 4.3, P = 0.001). Abnormal PT, APTT and plasma fibrinogen were more likely with platelet count below 80000 cell/μl (P = 0.046, P = 0.014 and P = 0.001, respectively). Eclampsia complicated with thrombocytopenia was associated with the most severe biochemical coagulopathy.
Conclusion: Thrombocytopenia frequently complicates eclampsia more than severe preeclampsia at platelet count levels below 80000 cell/μl. This level is discriminatory for biochemical coagulopathy, and it should prompt coagulation studies and warrant clinical vigilance.
Keywords: Coagulopathy; eclampsia; platelet counts; severe preeclampsia; thrombocytopenia; University of Benin Teaching Hospital (UBTH)
