Evaluation of Platelet and Coagulation Profiles Among Pregnant Women with Preeclampsia Attending Antenatal Clinics in Osun State, Nigeria.

Abstract

Background: Hypertensive disorders of pregnancy, especially preeclampsia and eclampsia, significantly contribute to maternal and perinatal morbidity and mortality in low-resource settings. This study assessed platelet function and coagulation abnormalities among pregnant women with preeclampsia and eclampsia attending antenatal clinics in Osun State, Nigeria. Methods: A hospital-based comparative cross-sectional study involving 210 pregnant women (70 normotensive, 70 with preeclampsia, and 70 with eclampsia) was conducted. Sociodemographic and clinical data were collected using structured questionnaires, while laboratory analyses evaluated platelet indices and coagulation parameters. Data were analysed using SPSS version 26.0, with statistical significance defined at p < 0.05. Results: Demographic characteristics were comparable across groups, except for parity, which was significantly higher among women with eclampsia (p = 0.038). Platelet counts decreased significantly with disease severity (240 ± 44 ×10⁹/L in normotensive women, 174 ± 40 ×10⁹/L in preeclampsia, and 129 ± 35 ×10⁹/L in eclampsia; p < 0.001). Conversely, MPV and PDW increased progressively across the groups (p < 0.001). Bleeding time, PT, and aPTT were significantly prolonged among women with hypertensive disorders of pregnancy, with the greatest abnormalities observed in eclampsia (p < 0.001). Fibrinogen and D-dimer levels also showed significant stepwise increases with disease severity (p < 0.001). Multivariate analysis identified thrombocytopenia and elevated MPV as independent predictors of both preeclampsia and eclampsia, while prolonged PT and aPTT were independently associated with eclampsia. Conclusion: Preeclampsia and eclampsia are associated with significant alterations in platelet function and coagulation parameters, reflecting progressive haemostatic imbalance. Incorporating routine haemostatic assessment into antenatal care may facilitate early identification of disease severity and improve maternal outcomes.