Accuracy of Platelet Parameters (PC, MPV, and PDW) as A Predictor of The Severity of Preeclampsia
Abstract
Objective: To evaluate the accuracy of platelet parameters—platelet count (PC), mean platelet volume (MPV), and platelet distribution width (PDW)—as predictors of preeclampsia severity.
Methods:A case-control study was conducted on 153 pregnant women with preeclampsia at Arifin Achmad Hospital from January 2019 to December 2020. Platelet indices (PC, MPV, PDW) were compared between 61 patients with severe preeclampsia and 92 with non-severe preeclampsia. ROC analysis determined predictive accuracy, with sensitivity and specificity calculated for selected cut-off values.
Results:Significant differences were found in PC (p=0.000), PDW (p=0.049), and MPV (p=0.012) between groups. ROC analysis showed PDW >12.3% had a sensitivity of 60.7% and specificity of 59.8%, while MPV >10.65 fL had a sensitivity of 62.3% and specificity of 64.1%. AUC values for PDW and MPV were 0.62 and 0.66, respectively, indicating weak predictive accuracy.
Conclusion:Although platelet parameters differ significantly between preeclampsia severity groups, their predictive value is limited. They should not be solely relied upon for assessing preeclampsia severity.
Akurasi Parameter Trombosit (PC, MPV, dan PDW) sebagai Prediktor Tingkat Keparahan Preeklampsia
Abstrak
Tujuan: Penelitian ini dilaksanakan pada pasien preeklampsia untuk mengevaluasi akurasi parameter trombosit—jumlah trombosit (PC), volume trombosit rata-rata (MPV), dan lebar distribusi trombosit (PDW)—sebagai prediktor tingkat keparahan.
Metode: Studi kasus-kontrol dilakukan pada 153 ibu hamil dengan preeklamsia di Rumah Sakit Arifin Achmad dari Januari 2019 hingga Desember 2020. Indeks trombosit (PC, MPV, PDW) dibandingkan antara 61 pasien dengan preeklamsia berat dan 92 pasien dengan preeklamsia tanpa gejala berat. Analisis ROC digunakan untuk menentukan akurasi prediktif, dengan perhitungan sensitivitas dan spesifisitas berdasarkan nilai cut-off tertentu.
Hasil: Terdapat perbedaan signifikan pada PC (p=0.000), PDW (p=0,049), dan MPV (p=0.012) antara kedua kelompok. Analisis ROC menunjukkan bahwa PDW >12.3% memiliki sensitivitas 60.7% dan spesifisitas 59.8%, sedangkan MPV >10.65 fL memiliki sensitivitas 62.3% dan spesifisitas 64.1%. Nilai AUC untuk PDW dan MPV adalah 0.62 dan 0.66, menunjukkan akurasi prediktif yang lemah.
Kesimpulan: Meskipun parameter trombosit menunjukkan perbedaan signifikan antara kelompok preeklamsia berat dan tidak berat, nilai prediktifnya terbatas. Parameter ini tidak dapat digunakan secara mandiri untuk menilai tingkat keparahan preeklamsia. Kata kunci: Preeklamsia, Jumlah Trombosit, Lebar Distribusi Trombosit, Volume Trombosit Rata-rata, Biomarker Prediktif
Keywords
Full Text:
PDFReferences
Hypertension G. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019;133(1):e1–25.
Opitasari C, Andayasari L. Parity, education level and risk for (pre-) eclampsia in selected hospitals in Jakarta. Heal Sci J Indones. 2014;5(1):35–9.
Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional Riskesdas 2018 [Internet]. Kementerian Kesehatan Republik Indonesia. Jakarta: Kemenkes RI; 2018. Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf
Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia—Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;76(14):1690–702.
AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag. 2016;12:477–80.
Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): New perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019.
Demirin H, Ozhan H, Ucgun T, Celer A, Bulur S, Cil H, et al. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res [Internet]. 2011;128(4):358–60. Available from: http://dx.doi.org/10.1016/j.thromres.2011.05.007
Tesfay F, Negash M, Alemu J, Yahya M, Teklu G, Yibrah M, et al. Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia. PLoS One [Internet]. 2019;14(11):0–10. Available from: http://dx.doi.org/10.1371/journal.pone.0225536
Yang S, Berdine G. The receiver operating characteristic (ROC) curve. Southwest Respir Crit Care Chronicles. 2017;5(19):34.
World Health Organization. The Asia-Pacific Perspective : Redefining Obesity and its treatment. 2000. p. 1–56.
Motedayen M, Rafiei M, Tavirani MR, Sayehmiri K, Dousti M. The relationship between body mass index and preeclampsia: A systematic review and meta-analysis. Int J Reprod Biomed. 2019;17(7):465–74.
Shao Y, Qiu J, Huang H, Mao B, Dai W, He X, et al. Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: A birth cohort study in Lanzhou, China. BMC Pregnancy Childbirth. 2017;17(1):2–9.
Cunningham, F. Gary, Leveno, Kenneth J., Bloom, Steven L., Dashe, Jodi S. SC. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2018.
Gupta A, Gaur BS, Mishra KB, Dubey I. A comparison of platelet count in severe preeclampsia, mild preeclampsia and normal pregnancy. Int J Res Med Sci. 2018;6(2):671.
Srivastava M, Bali S, Pandey J, Nayar V, Talib VH. Pregnancy induced hypertension and antithrombin-III. Indian J Pathol Microbiol. 1995 Jul;38(3):257–60.
kamel Ammar WAE, Abd El MAEH, Hei MAG, Mohamed MI. Evaluation of platelet indices and their significance in Preeclampsia. Nat Sci. 2014;12(3):147–53.
Jambhulkar S, Shrikhande A, Shrivastava R, Deshmukh K. Coagulation profile in pregnancy induced hypertension. Indian J Hematol Blood Transf. 2001;19(1).
Reddy SG, Rajendra Prasad CSB. Significance of platelet indices as severity marker in nonthrombocytopenic preeclampsia cases. J Lab Physicians. 2019;11(03):186–91.
ONISAI M, VASILACHE V. The endothelial-platelet dysfunction in preeclampsia. Mædica A J Clin Med. 2007;2(3):214.
Karateke A, Kurt RK, Baloğlu A. Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia. Ginekol Pol. 2015;86(5):372–5.
DOI: http://dx.doi.org/10.24198/obgynia.v8i2.858
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
_CROSREF22.jpg)
