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ORIGINAL ARTICLE
Year : 2019  |  Volume : 18  |  Issue : 1  |  Page : 36-42

The significance of (platelet/white blood cell) counts ratio in screening for high risk for preeclampsia and its related complications


1 Department of Gynecoloy and Obstetrics, Al Yarmook Teaching Hospital, Al Mustansiriyah Medical College, Baghdad, Iraq
2 Arab Board Candidate, Al Yarmook Teaching Hospital, Baghdad, Iraq

Correspondence Address:
Dr. Wisam Akram
Al Yarmook Teaching Hospital, Al Mustansiriyah Medical College, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJ.MJ_35_18

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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 screening ratio for preeclampsia and its related complications. Patients and Methods: We have taken a total of 104 primigravida patients, each one is corresponding to the gestational ages (GA) 20–34 weeks, and seven patients per each week for initial PW ratio assessment. In addition, all women were told to come again at 34 weeks of gestation for reassessment of PW ratio (platelet/WBC) count, and a meticulous ultrasound examination for intrauterine growth restriction (IUGR) as well as biophysical profile. Results: At the end of the study, we subdivided the 104 initial sample into three subgroups; normal women (n = 76); women with preeclampsia but no IUGR (n = 16); and women with preeclampsia and 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 of the third degree between PW ratio and GA has shown a significant correlation between PW ratio and GA. The correlation between them was statistically significant, yet the distribution of PW was normal in distribution P = 0.16. In addition, since all screening test should be subject to Weibull distribution, we challenged the PW ratio against this distribution and was found to be positive P = 0.3 by using the Kolmogorov–Smirnov test. At last, logistic regression was constructed to evaluate the correlation between PW ratio and the number of infants with IUGR, and a highly positive correlation was found P = 0.0001. Moreover, PW was significant with all the items of the biophysical profile which includes body posture, gross body movement, respiratory fetal movement, oligohydramnios, and NST. At last, we have constructed easily used chart and reference tables for PW ratio between 20 and 34 weeks; hence, they can be used in clinical practice to verify this ratio among women with preeclampsia. Conclusion: A simple easily to calculate ratio has been constructed which has been shown in this paper to be significantly correlated to preeclampsia and IUGR, and from this ratio, easy reference table and figure have been constructed. Yet, by no mean, we call that this ratio or table is used as a substitute for clinical methods to screen or to diagnose preeclampsia until its significance is evaluated by further trials. However, it may be of value as an adjuvant test to other standard tests used for preeclampsia screening or monitoring.


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