Evaluation of Leucocyte and Platelet indices in Preeclampsia compared to normotensive Asian Indian pregnant women

Hyperactivation of inflammatory and immunologic responses in pre-eclampsia causes a marked increase in neutrophil count and modulation of neutrophil function toward greater production of superoxide compared with nitric oxide, which results in endothelial damage and dysfunction. Pre-eclampsia is also known to cause platelet activation, manifesting as low platelet count and high mean platelet volume (MPV).

Systemic immune inflammation indices derived from peripheral blood cells have recently attracted much attention because they are easily measurable and available. Abnormal changes in white blood cells counts have been observed in Preeclampsia, although the role of these systemic inflammatory indicators in clinical assessment, differential diagnosis and prognosis evaluation of PE remains unclear.

Hence this prospective comparative observational studyis being planned to assess the level of leucocyte and platelet indices in preeclampsia in Asian Indian women and comparison with normotensive pregnant women and to study the correlation of these indices with severity of preeclampsia as well as correlation  among various parameters as none of the previous prospective study has evaluated correlation between these indices.

The study group will comprise of 40 pregnant women aged 18–40 years who are diagnosed with pre-eclampsia (blood pressure elevation ≥140/90 mm Hg on two occasions 4 hours apart with proteinuria or any of the severe features of pre-eclampsia: thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, cerebral or visual disturbances). 80 gestational age-matched, healthy pregnant women will be enrolled into the control group. In this study,  ratio of cases : controls will be maintained as 1:2; so as to get adequate representation among the controls and also to compensate for controls who will be likely to develop preeclampsia in the late stage of pregnancy, as such cases will be excluded from analysis. So sample size for cases and control will be 40 and 80 respectively.

Primary objectives of this study will be to assess the level of leucocyte and platelet indices (NLR, MLR, PLR, PDW, MPV) in preeclampsia in Asian Indian women and comparison with normotensive pregnant women and to correlate these indices with severity of preeclampsia

Secondary objectives will be to find the correlation among NLR, MLR, PLR, PDW, MPV; to correlate these markers with adverse feto-maternal and neonatal outcome; to evaluate other haematological markers such as RDW, Plateletcrit, absolute values of platelet count in preeclampsia.