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Published on: June 29, 2013
Platelet Changes in Pregnancies with Severe Early Fetal Intrauterine Growth Restriction
Anca Marina Ciobanu1,2, Anca Maria Panaitescu1,2, Nicolae Gica1,2
1Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Insights
Severe early intrauterine growth restriction (IUGR) is linked to maternal endothelial damage and platelet consumption, indicated by lower platelet counts and higher mean platelet volume (MPV). These simple tests may signal placental insufficiency.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Perinatology
Background:
- Severe early onset intrauterine growth restriction (IUGR) affects fetal development.
- Platelet indices like count and mean platelet volume (MPV) may reflect maternal health status.
- Preeclampsia (PE) is a known complication associated with IUGR and altered coagulation.
Purpose of the Study:
- To investigate changes in platelet count and MPV in severe early IUGR.
- To compare these parameters between IUGR cases and normal pregnancies.
- To assess the influence of preeclampsia (PE) on these platelet indices in IUGR.
Main Methods:
- Retrospective analysis of pregnancies with severe early IUGR (birthweight <5th percentile, delivery before 32 weeks).
- Comparison with a control group of normal singleton pregnancies delivered at term.
- Complete blood count (CBC) data, including platelet count and MPV, analyzed within 7 days prior to delivery.
Main Results:
- Significant differences observed in platelet count and MPV between IUGR and control groups.
- IUGR cases exhibited lower platelet counts and higher MPV values.
- No significant difference in these parameters was found when PE was associated with IUGR.
Conclusions:
- Severe early IUGR, even without clinical PE, may indicate maternal endothelial damage and platelet consumption.
- Platelet count and MPV are potential simple indicators of placental insufficiency.
- Further prospective studies are needed to confirm the mechanistic link and predictive value for adverse outcomes.
Abstract:
Background and Objectives: In this study, we investigated the changes of platelet count and other platelet indices, such as mean platelet volume (MPV), in cases with severe early intrauterine fetal growth restriction (IUGR). Materials and Methods: We retrospectively analyzed all pregnancies diagnosed with severe early onset IUGR, that were followed up in our hospital between 2010 and 2015 (before implementation of screening and prophylaxis with aspirin). Pregnancies which resulted in birth of a newborn with a birthweight less than 5th percentile for gestational age, that required delivery for fetal or maternal indication before 32 weeks, were selected for the IUGR group. The IUGR cases were divided into two groups according to preeclampsia (PE) association. All cases with a complete blood count (CBC) performed within 7 days prior to delivery were included in the study, as the IUGR group. The control group included normal singleton pregnancies, delivered at term, with birthweight above 10th centile and a CBC taken at 30-32 weeks. Results: There was a significant difference in platelet count and MPV values between the IUGR group and control. Cases with IUGR presented lower platelet count and higher MPV values; there was no significant difference of these parameters when PE was associated with IUGR. Conclusions: Our results suggest that in cases of severe early IUGR, even in the absence of clinically diagnosed PE, there may be maternal endothelial damage and platelet consumption in the systemic and uteroplacental circulation. Platelet count and MPV values are simple and widely available laboratory tests that might be used as indicator of placental insufficiency; however, prospective data are required to establish the mechanistic link and to which extent these parameters are good predictors of severity or adverse perinatal outcomes.
