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Platelet count estimation in pregnancy-induced hypertension and assessment of the degree of thrombocytopenia

Background: Gestational thrombocytopenia is the most common cause of thrombocytopenia and pregnancy-induced hypertension (PIH) is the second common cause. The degree and the incidence of thrombocytopenia depend on the severity of the disease process. Lower is the platelet count, greater will be the maternal and fetal morbidity and mortality. Early diagnosis and assessment of severity of PIH is necessary to prevent complications such as HELLP syndrome and maternal and fetal morbidity and mortality. Therefore, platelet count plays an important role in the functional evaluation of the hemostatic system. 
 
Aims and Objectives: The aims of the study were as follows: (i) To estimate the platelet count in PIH and (ii) to assess the degree of thrombocytopenia in PIH based on platelet count. 
 
Materials and Methods: The study group consisted of 120 pregnant women, of which 90 were diagnosed to be with PIH, with varying severity. Thirty subjects were control group with no signs of hypertension. Blood pressure (BP) was recorded and platelet count was assessed by peripheral smear method (PM) in all 120 pregnant women. 
 
Results: Platelet numbers done by peripheral smear were found to be 2.56 ± 0.89 lac/mm3 in mild PIH, 1.95 ± 1.12 lac/mm3 in pre-eclampsia, 1.34 ± 0.91 lac/mm3 in eclampsia, and 3.13 ± 0.96 lac/mm3 in control group. The platelet count by the automatic analyzer was 2.47 ± 0.10 lac/mm3 in mild PIH, 1.82 ± 1.02 lac/mm3 in pre-eclampsia, 1.29 ± 0.83 lac/mm3 in eclampsia, and 2.92 ± 0.98 lac/mm3 in control group. This shows that there is a decrease in platelet count with increase in severity of the disease. No statistical significant difference seen in both methods. 
 
Conclusion: Platelet count serves as an important tool for diagnosing the severity of the disease. Estimation of platelets from PM is a simple, rapid, easier, and cheaper method which can be used even at rural setup where automated counters are not available.