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Published in: Archives of Gynecology and Obstetrics 6/2019

01-06-2019 | Pre-Eclampsia | Maternal-Fetal Medicine

The immature platelet fraction in hypertensive disease during pregnancy

Authors: Ulrike Bernstein, Thorsten Kaiser, Holger Stepan, Alexander Jank

Published in: Archives of Gynecology and Obstetrics | Issue 6/2019

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Abstract

Purpose

The aim of our study was to elucidate the role of IPF in preeclampsia, because the immature platelet fraction (IPF) is available in most emergency departments. A number of parameters have been introduced to diagnose preeclampsia/HELLP syndrome. The defined cutoffs of angiogenic and antiangiogenic parameters, soluble fms-like tyrosine kinase 1 and placental growth factor, have been approved for clinical routine. However, these parameters need complex analysis and are expensive.

Methods

The data of 69 pregnant women between 20 and 42 weeks of gestation were analyzed in this retrospective monocentric study. 28 of them had preeclampsia, HELLP syndrome or partial HELLP syndrome fitting the Tennessee criteria (study group 1). Furthermore, 41 normotensive pregnant women were included as controls (study group 2). In both groups the IPF was analyzed.

Results

In this study, we demonstrated that the values of IPF were significantly higher in patients with hypertensive diseases than in normotensives, but could not distinguish between preeclampsia and HELLP syndrome. The absolute number of immature platelets of women with preeclampsia was significantly higher and those of HELLP syndrome were significantly lower than values of healthy women. The absolute number of immature platelets as well as mature thrombocytes helps to distinguish between HELLP syndrome and preeclampsia.

Conclusion

IPF levels are higher in women with hypertensive pregnancy than in normotensive controls. They could be used to diagnose hypertensive diseases in pregnancy. To distinguish between preeclampsia and HELLP syndrome, thrombocytes or the absolute number of immature platelets is needed.
Literature
1.
go back to reference Magee LA, Abalos E, von Dadelszen P, Sibai B, Easterling T, Walkonshaw S (2011) How to manage hypertension in pregnancy effectively. Br J Clin Pharmacol 72:394–401CrossRefPubMedPubMedCentral Magee LA, Abalos E, von Dadelszen P, Sibai B, Easterling T, Walkonshaw S (2011) How to manage hypertension in pregnancy effectively. Br J Clin Pharmacol 72:394–401CrossRefPubMedPubMedCentral
2.
go back to reference Moussa HN, Arian SE, Sibai BM (2014) Management of hypertensive disorders in pregnancy. Women’s Health 10:385–404CrossRefPubMed Moussa HN, Arian SE, Sibai BM (2014) Management of hypertensive disorders in pregnancy. Women’s Health 10:385–404CrossRefPubMed
3.
go back to reference Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C et al (2005) The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. Br Med J 330:576–580CrossRef Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C et al (2005) The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. Br Med J 330:576–580CrossRef
4.
5.
go back to reference Sibai BM (1990) The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol 162:311–316CrossRefPubMed Sibai BM (1990) The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol 162:311–316CrossRefPubMed
7.
go back to reference Stepan H, Jank A (2009) Angiogene Faktoren und ihre Rolle in der Entstehung und Vorhersage der Präeklampsie. ZNG 213:101–105 Stepan H, Jank A (2009) Angiogene Faktoren und ihre Rolle in der Entstehung und Vorhersage der Präeklampsie. ZNG 213:101–105
8.
go back to reference Verlohren S, Herraiz I, Lapaire O, Schlembach D, Moertl M, Zeisler H et al (2012) The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol 206(58):e1–e8 Verlohren S, Herraiz I, Lapaire O, Schlembach D, Moertl M, Zeisler H et al (2012) The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol 206(58):e1–e8
9.
go back to reference Verlohren S, Herraiz I, Lapaire O, Schlembach D, Zeisler H et al (2014) New gestational phase-specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia. Hypertension 63:346–352CrossRefPubMed Verlohren S, Herraiz I, Lapaire O, Schlembach D, Zeisler H et al (2014) New gestational phase-specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia. Hypertension 63:346–352CrossRefPubMed
11.
go back to reference Verlohren S, Stepan H, Dechend R (2012) Angiogenic growth factors in the diagnosis and prediction of preeclampsia. Clin Sci 122:43–52CrossRefPubMed Verlohren S, Stepan H, Dechend R (2012) Angiogenic growth factors in the diagnosis and prediction of preeclampsia. Clin Sci 122:43–52CrossRefPubMed
12.
go back to reference Everett TR, Garner SF, Lees CC, Goodall AH (2014) Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies. J Thromb Haemost 111:1177–1179CrossRef Everett TR, Garner SF, Lees CC, Goodall AH (2014) Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies. J Thromb Haemost 111:1177–1179CrossRef
13.
go back to reference Rinder HM, Bonan JL, Anandan S, Rinder CS, Rodrigues PA et al (1994) Noninvasive measurement of platelet kinetics in normal and hypertensive pregnancies. Am J Obstet Gynecol 170:117–122CrossRefPubMed Rinder HM, Bonan JL, Anandan S, Rinder CS, Rodrigues PA et al (1994) Noninvasive measurement of platelet kinetics in normal and hypertensive pregnancies. Am J Obstet Gynecol 170:117–122CrossRefPubMed
14.
go back to reference Kazmi R, Cooper A, Lwaleed B (2011) Platelet function in pre-eclampsia. Semin Thromb Hemost 37:131–136CrossRefPubMed Kazmi R, Cooper A, Lwaleed B (2011) Platelet function in pre-eclampsia. Semin Thromb Hemost 37:131–136CrossRefPubMed
15.
go back to reference Ratsch U, Kaiser T, Stepan H, Jank A (2017) Evaluation of bone marrow function with immature platelet fraction in normal pregnancy. Hypertens Pregnancy 10:70–73CrossRef Ratsch U, Kaiser T, Stepan H, Jank A (2017) Evaluation of bone marrow function with immature platelet fraction in normal pregnancy. Hypertens Pregnancy 10:70–73CrossRef
16.
go back to reference Moraes D, Munhoz PT, Pinheiro da Costa BE, Hentschke MR, Sontag F, Silveira Lucas L et al (2016) Immature platelet fraction in hypertensive pregnancy. Platelets 27:333–337CrossRefPubMed Moraes D, Munhoz PT, Pinheiro da Costa BE, Hentschke MR, Sontag F, Silveira Lucas L et al (2016) Immature platelet fraction in hypertensive pregnancy. Platelets 27:333–337CrossRefPubMed
Metadata
Title
The immature platelet fraction in hypertensive disease during pregnancy
Authors
Ulrike Bernstein
Thorsten Kaiser
Holger Stepan
Alexander Jank
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Keyword
Pre-Eclampsia
Published in
Archives of Gynecology and Obstetrics / Issue 6/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05102-2

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