Mean platelet volume: Association with adverse neonatal outcome

Abstract

The aim of the study was to investigate on a possible association between maternal mean platelet volume (MPV) and oxygen-metabolic changes in pregnancies affected by altered maternal-fetal Doppler velocimetry. We considered the altered maternal-fetal Doppler velocimetry group (n = 57) pregnant women admitted to our Institution for a pregnancy complication associated to the event Pre-eclampsia (PE) and intrauterine growth retardation (IUGR), with altered Doppler velocimetry in the umbilical artery ( UA) (high pulsatility index, absence or reverse end diastolic flow (ARED), blood flow cephalisation) and/or bilateral increased resistance in uterine arteries. Out of these cases, 25 pregnancies were complicated by PE and 32 pregnancies were complicated by IUGR. We included 145 normotensive third trimester pregnant women as a normal maternal-fetal Doppler velocimetry control group. From all women, 20 ml of whole venous blood was obtained from the antecubital vein soon after Doppler velocimetry evaluation. MPV was significantly higher in women with abnormal Doppler velocimetry compared to those with normal Doppler velocimetry (8.0 fl [7.0-8.7] vs. 9.1 fl [8.0-10.6], <0.001. Values are median [interquartiles]). We performed a ROC curve in order to find an MPV cut-off able to predict an uneventful event in Doppler velocimetry compromised fetuses (neonatal O(2) support > 48 hrs or intubation and/or pH < 7.2 at umbilical blood gas analysis (UBGA)). An MPV > or = 10 fl was significantly related to the former diagnostic endpoints compared to that of non-compromised fetuses (sensitivity: 45%, specificity: 89.7%, 95 CI: 18.8-66, p < 0.01). Our study suggests that pregnancies affected by Doppler velocimetry alterations, an MPV value > or = 10 fl may be associated with severe oxygen support and/or low UA ph at birth.

Can platelet count and mean platelet volume during the first trimester of pregnancy predict preterm premature rupture of membranes?

“…In another study, Gioia et al . reported that MPV ≥ 10fL may be associated with adverse neonatal outcomes in women affected by abnormal uterine artery Doppler findings . The role of platelets in the pathophysiology of these studies was thrombosis secondary to inflammation.…”

Increased MPV Is Not a Significant Predictor for Preeclampsia During Pregnancy

“…Moreover, Dundar et al showed that MPV increase during pregnancy, but it is more prominent in cases developing preeclampsia . Investigators described two different cutoff values, one was 8.5 fL (with a sensitivity of 78% and specificity of 86%) to determine risk of preeclampsia and the other was 10 fL (femtolitre) (with a sensitivity of 45% and specificity of 89.7%) to define the chance of unfavorable neonatal outcome (the necessity of severe oxygen support) . A combination of reduced platelet count and elevated MPV has a sensitivity of 90% and specificity of 83.3% in predicting preeclampsia .…”

Changes in Platelet Indices during Pregnancy as Potential Markers for Prediction of Preeclampsia Development

“…They suggested that MPV stands as a marker for prediction of PE development. Furthermore, Gioia et al proposed that a MPV cut-off value ≥ 10 fL may be considered as a further significant parameter that is able to predict unfavourable neonatal outcome in women affected by altered uterine artery Doppler velocimetry [37].…”