Submit your papersSubmit Now
For Enquiries: [email protected]
IIARD LogoIIARD

Clinical Characteristics and Peripheral Blood Film Findings of Pre- Eclamptic and Normotensive Pregnant Women Attending Antenatal Clinic in Southern Nigeria

Odianosen Sunday Otumu, David Olaniyi Olanrewaju, Eseoleleti Christopher, Okpunu, Tabitha Obulimi Otumu, Omolade Augustina Awodu, Chikezie Chinedu, Nwankwo, Mercy Ofunami DicIjiewere

Abstract

Pre-eclampsia is an obstetric disorder that affects a tenth of pregnancies worldwide. It has a growing burden in Nigeria with a prevalence ranging from 5-10%. Normal pregnancy is associated with changes in haematological indices. This hospital-based case-control observational study was carried out to determine the clinical characteristics and peripheral blood film picture in pre-eclamptic patients at diagnosis and suitably matched controls. It involved 65 pre-eclamptic women as the test group, and 65 age, trimester and parity matched normotensive, non-proteinuric pregnant women as control group. The test group was classified clinically as having mild or severe pre-eclampsia using the American College of Obstetricians and Gynecologists classification. Clinical information of pregnant women was obtained from their electronic medical records with respective patient’s consent. The LB-1270 compound biological trinocular digital microscope with camera and software (5.0MP), LCD and Infinite Optical System was used to visualize peripheral blood films. The result of the study shows that the BMI of pregnant females with pre-eclampsia (25.99±2.3) and normotensive pregnant females (25.21±1.9) were within the reference interval for trimester-matched Body mass index (BMI) and there was no evidence of fetal compromise. Seventeen (13.1%) of the participants were pale at presentation, and 24.6% of pre-eclamptic subjects in the second trimester had features of microangiopathic haemolytic anaemia (MAHA). In conclusion, pre-eclampsia had significant haemolytic changes and altered physiological balance characterized by marked changes in clinical features.

Keywords

Pre-eclampsiaBlood filmnormotensiveclinical features

References

1. Osungbade KO, Ige OK. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening. J Pregnancy. 2011:1–6. 2. Han L, Liu X, Li H, Zou J, Yang Z, Han J. Blood Coagulation Parameters and Platelet Indices?: Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia. PLOS One. 2014;9(12):1–14. 3. Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi JM. Pre-eclampsia: Pathophysiology, diagnosis, and management. Vasc Health Risk Manag. 2011;7(1):467-474. 4. Fisher SJ, McMaster M, Roberts JM. The Placenta in Normal Pregnancy and Preeclampsia. In: Taylor RN, Roberts JM, Cunningham FG, Lindheimer MD (eds). Chesley’s Hypertensive Disorders in Pregnancy. 4th edition. London. Academic press; 2014: 81-112. 5. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and gynecology, 2013: 122(5), 1122–1131 6. Repke JT. Hypertension in pregnancy - II. Md Med J. 2013;36(7):565–567. 7. Sibai BM. Etiology and management of postpartum hypertension-preeclampsia. Am J Obstet Gynecol. 2012;206(6):470–475. 8. Hypertensive Disorders. In: Cunningham GF, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM (eds). Williams Obstetrics, 25th Edition. New York. McGraw Hill; 2018: 715-719 9. Myatt L, Clifton RG, Roberts JM, Catherine Y, Hauth JC, et al. First-Trimester Prediction of Preeclampsia in Low-Risk Nulliparous Women. Obstet Gynecol. 2013;119(6):1234– 1242. 10. Louise K.C. Pre-eclampsia and other Disorders of Placentation. In: Philip NB, Louise CK (eds). Obstetrics by Ten Teachers. 19th Edition. London: Hodder Arnold. 2011:120-130. 11. Redman CWG, Sargent IL. Immunology of Pre-Eclampsia. Am J Reprod Immunol. 2010;63(6):534–543. 12. Thornton JG, Macdonald AM. Twin mothers, pregnancy, hypertension and pre-eclampsia. BJOG An Int J Obstet Gynaecol. 1999;106(6):570–575. 13. Heilmann L, Rath W, Pollow K. Hemostatic abnormalities in patients with severe preeclampsia. Clin Appl Thromb. 2007;13(3):285–291. 14. Y?lmaz ZV, Y?lmaz E, Küçüközkan T. Red blood cell distribution width: A simple parameter in preeclampsia. Pregnancy Hypertens. 2016;6(4):285–287. 15. Hernández Hernández JD, Villaseñor OR, Del Rio Alvarado J, Lucach RO, Zárate A, Saucedo R, et al. Morphological Changes of Red Blood Cells in Peripheral Blood Smear of Patients with Pregnancy-related Hypertensive Disorders. Arch Med Res. 2015;46(6):479–483. 16. Shetty J, Rao S, Kulkarni MH. Hematological Changes in Pregnancy-induced Hypertension. Int J Sci Study. 2016;4(5):216–221. 17. Karumanchi AS, Rana S, Taylor RN. Angiogenesis and preeclampsia. In: Taylor RN, Roberts JM, Cunningham FG, Lindheimer MD (eds). Chesley’s Hypertensive Disorders in Pregnancy. 4th edition. London. Academic press; 2014:113–132. 18. Chaturvedi S, McCrae KR. Thrombocytopenia in pregnancy. In Platelets in Thrombotic and Non-Thrombotic Disorders: Pathophysiology, Pharmacology and Therapeutics: an Update. Springer International Publishing. 2017:813-823.19. Hajian-Tilaki K. Sample size estimation in epidemiologic studies. Casp J Intern Med. 2011;2(4):289–298. 20. Ganiyu AO, Davies C, Ogundahunsi MA, Abioye O, Jaye O, Ayebatonyo M, et al. Maternal and neonatal outcomes of pre-eclampsia in African black women, south west Nigeria. Greener J Med Sci. 2015;5(4):67–76. 21. Laffan MA, Manning RA. Investigation of Haemostasis. In: Bain BJ, Bates I, Laffan MA, Lewis MS (eds). Dacie and Lewis Practical Haematology. 12th edition. London: Elsevier Health Sciences; 2017: 409–411. 22. Hypertensive Disorders. In: Cunningham GF, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM (eds). Williams Obstetrics, 25th Edition. New York. McGraw Hill; 2018: 710–754. 23. Verma MK, Kapoor P, Yadav R, Manohar RK. Risk Factor Assessment for Preeclampsia: A Case Control Study. Int J Med Public Heal. 2017;7(3):172–177. 24. Das S, Das R, Bajracharya R, Baral G, Jabegu B, Odland JØ, et al. Incidence and risk factors of pre-eclampsia in the paropakar maternity and women’s hospital, Nepal: A retrospective study. Int J Environ Res Public Health. 2019;16(19):1–8. 25. Ogugua DE, Iwuagwu J. Prevalence of Preeclampsia Amongst Pregnant women in a multispecialty hospital in southeastern Nigeria: A retrospective cross-sectional study. Abia State University Medical Students’ Association Journal. 2024, 15(1): 2023. https://www.ajol.info/index.php/asumsaj/issue/view/23405 26. Triche EW, Uzun A, Dewan AT, Kurihara I, Liu J, Occhiogrosso R, et al. Bioinformatic approach to the genetics of preeclampsia. Obstet Gynecol. 2014;123(6):1155–1161. 27. Shahabi A, Wilson ML, Lewinger JP, Goodwin TM, Stern MC, Ingles SA. Genetic admixture and risk of hypertensive disorders of pregnancy among Latinas in Los Angeles County. Epidemiology. 2013;24(2):285–294. 28. Yang J, Pearl M, DeLorenze GN, Romero R, Dong Z, Jelliffe-Pawlowski L, et al. Racialethnic differences in midtrimester maternal serum levels of angiogenic and antiangiogenic factors. Am J Obstet Gynecol. 2016;215(3):359.e1-359.e9.