COAGULATION PARAMETERS, PLATELET COUNT AND D-DIMER LEVEL CHANGES IN PREECLAMPSIA AND NORMAL PREGNANCIES IN KHARTOUM STATE
Einass Abdelkhalig Ali, Marwa Greeballa Alamin*, Mozdalifa Osman abdoalrhman, Ashgan Abdul Haleim Osman
ABSTRACT
Background: Preeclampsia (P-E) is an obstetric disorder with high morbidity and mortality rates but without clear pathogenic. The dysfunction of the blood coagulation- fibrinolysis system is a silent characteristic of preeclampsia that varies in severity, and necessitates different treatments. A better understanding of the abnormalities of coagulation in the preeclamptic and eclamptic patient may allow the clinician to provide improved management & possibly peripartum therapy. Therefore, it is necessary to find suitable predictors for the onset and severity of preeclampsia. Aim and objective: this study designed to compare the coagulation profile, platelet count and D-dimer level in normal pregnancy, severe preeclampsia, and preeclampsia patients to determine the potential indicator of the onset and the severity of preeclampsia. Materials and methods: The study was concluded in the Omdurman Maternity hospital and Saudi hospital in Khartoum state during period between May and October 2016.A 50 confirmed cases of preeclamptic/severs preeclamptic patients and 50 normal pregnant women in the third trimester were recruited. Coagulation profile including prothrombin time (PT) activated partial thromboplastin time (APTT), Platelet count and D-dimer test were measured and compared among the study populations. Results: Mean value of platelet count was significantly lower in the case group than in control 178. 36 versus 267. 64X109, (P= 0.000). Mean vales of APTT (34.60versus 37.07sec) and PT (10.97 versus, 12.54sec) tests, were significantly reduced in control than case group (p= 0.00).D-dimer level (2.21 versus 1.04mg/ml) was significantly greater in case than control group (p=0.00). All coagulation parameters and platelet count did not show any statistical differences between sever preeclamptic and preeclamptic groups .While D.dimer level was markedly greater in sever preeclamptic cases than preeclamptic cases (2.73versus 1.10mg/ml (p= 0.000). Conclusion: Raised D-dimer is fairly good indicator of severe preeclampsia and alarming sign for aggressive treatment.
Keywords: PT, APTT, platelet count, D-dimer.
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