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The Significance of (Platelet/White Blood Cell) Counts Ratio in Screening for High Risk for Preeclampsia and Its Related Complications

Authors: Wisam Akram --- Duha Muaeed
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2019 Volume: 18 Issue: 1 Pages: 36-42
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: We have taken a standpoint that the scope of the platelet count or its variance is significantly higher in pregnancy; 50,000-6,00, 000 compared to the white blood cells(WBC) 9,000-11,000. Hence, their ratio may be a useful marker in predicting preeclampsia.Aim of the Study: The aim of this study was to verify that placental weight (PW ratio) or platelet/WBC count might be a useful screeningratio for preeclampsia and its related complications. Patients and Methods: We have taken a total of 104 primigravida patients, each one iscorresponding to the gestational ages (GA) 20–34 weeks, and seven patients per each week for initial PW ratio assessment. In addition, allwomen were told to come again at 34 weeks of gestation for reassessment of PW ratio (platelet/WBC) count, and a meticulous ultrasoundexamination for intrauterine growth restriction (IUGR) as well as biophysical profile. Results: At the end of the study, we subdivided the 104initial sample into three subgroups; normal women (n = 76); women with preeclampsia but no IUGR (n = 16); and women with preeclampsiaand IUGR (n = 12). There was a statistically significant difference between the three groups with regard to systolic, diastolic, and PW ratio.In addition, the PW ratio was significantly different among the three subgroups using the analysis of variance test. Nonlinear polynomial ofthe third degree between PW ratio and GA has shown a significant correlation between PW ratio and GA. The correlation between them wasstatistically significant, yet the distribution of PW was normal in distribution P = 0.16. In addition, since all screening test should be subject toWeibull distribution, we challenged the PW ratio against this distribution and was found to be positive P = 0.3 by using the Kolmogorov–Smirnovtest. At last, logistic regression was constructed to evaluate the correlation between PW ratio and the number of infants with IUGR, and ahighly positive correlation was found P = 0.0001. Moreover, PW was significant with all the items of the biophysical profile which includesbody posture, gross body movement, respiratory fetal movement, oligohydramnios, and NST. At last, we have constructed easily used chartand reference tables for PW ratio between 20 and 34 weeks; hence, they can be used in clinical practice to verify this ratio among womenwith preeclampsia. Conclusion: A simple easily to calculate ratio has been constructed which has been shown in this paper to be significantlycorrelated to preeclampsia and IUGR, and from this ratio, easy reference table and figure have been constructed. Yet, by no mean, we call thatthis ratio or table is used as a substitute for clinical methods to screen or to diagnose preeclampsia until its significance is evaluated by furthertrials. However, it may be of value as an adjuvant test to other standard tests used for preeclampsia screening or monitoring.

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