Coagulation Factors in Severe Preeclampsia

Background: Preeclampsia is an idiopathic multisystem disorder specific to human pregnancy and the puerperium and hematological abnormalities may develop in preeclamptic women. This study was designed to determine coagulation parameters in patients with severe preeclampsia in Shiraz, southern Iran. Methods: From 2002 to 2005, coagulation indices including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPPT), plasma fibrinogen, and fibrin degradation products (FDP) were measured within 24 hours of admission for fifty women with severe preeclampsia and fifty normal pregnant women. The patients with coagulopathies were excluded. Abnormal coagulation indices were compared between the two groups. Results: The mean value of platelet counts were significantly lower while the mean values of aPPT and FDP were higher in the preeclamptic patients. However, the mean values of plasma fibrinogen and PT did not show any statistical difference between these two groups. Fifty percent of the patients with severe preeclampsia showed thrombocytopenia, 10% prolonged PT, 30% prolonged PTT, 28% hypofibrinogenemia, and 32% elevated FDP. Prolonged aPTT was seen in 6% of patients with platelet counts of more than 150×10/mm at the admission time. However, these patients showed evidence of coagulopathies and needed to receive blood or blood products later in their hospital course. Conclusion: In case an abnormal platelet count or aPTT is detected in a patient with severe preeclampsia, a coagulopathic disorder should be clinically suspected.