Clinical Study Of Platelet Parameters And Coagulation Parameters In Pregnant Women With Posterior Reversible Encephalopathy Syndrome In Pre-eclampsia Or Eclampsia

Objective:To explore the variation tendency of platelet parameters and coagulation parameters in pregnant women with preeclampsia-eclampsia complicated with posterior reversible encephalopathy syndrome(PRES)and its correlation with PRES.Methods:This study was conducted in Fujian Maternal and Child Care Hospital between June2011 and June 2017.320 pregnant women with preeclampsia-eclampsia and normal term pregnancy were selected as the research subjects.They were divided into three groups,including 64 cases of preeclampsia-eclampsia complicated with PRES as group PRES,128 cases of preeclampsia,severe preeclampsia and eclampsia with normal MRI examination as group preeclampsia,and 128 cases of normal full-term pregnancy and delivery as group normal.We collected and retrospectively analyzed the general clinical data,complications,related laboratory parameters,imaging examination and perinatal outcome and complications of the threre groups.The platelet parameters [ platelet count(PLT),mean platelet volume(MPV),plateletcrit(PCT),platelet distribution width(PDW)],blood coagulation indexes [ prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),international normalized ratio(INR),fibrin(ogen)degradation products(FDP),fibrinogen(FIB),D-dimer ],biochemical indexes [ blood lipids,liver function,kidney function ],and maternal complications and perinatal outcomes were analyzed,in order to explore the correlation between the related laboratory parameters and the PRES,and to evaluate the predictive value of PLT / MPV in the diagnosis of PRES.Results:1.Among platelet parameters,compared with the group normal,the PLT?PCT decreased and MPV?PDW increased in the group PRES and the group preeclampsia,and the difference was statistically significant(P < 0.05);compared with the group preeclampsia,PLT,PCT decreased and PDW increased in group PRES,the difference was statistically significant(P < 0.05).2.The PLT/MPV ratio in group PRES was(15.49�8.55),the PLT/MPV ratio in group preeclampsia was(18.59�7.89),and the PLT/MPV ratio in group normal was(23.32�7.69).Compared with the group normal,the PLT/MPV in group PRES and preeclampsia decreased,the difference was statistically significant(P < 0.05);compared with the group preeclampsia,the PLT/MPV in group PRES decreased,the difference was statistically significant(P < 0.05).3.Among blood coagulation index,compared with the group normal,PT,APTT and INR decreased and TT,FIB,FDP,D-dimer increased in group PRES and preeclampsia,the difference was statistically significant(P < 0.05);compared with the group preeclampsia,INR decreased and TT,FDP,D-dimer increased in group PRES,the difference was statistically significant(P < 0.05).4.Among lipid parameters,compared with the group normal,triglyceride(TG),total cholesterol(TC),apolipoprotein-B(Apo-B)increased and apolipoprotein-A1(Apo-A1),high density lipoprotein(HDL)decreased in group PRES,the difference was statistically significant(P < 0.05);compared with the group preeclampsia,Apo-B and low density lipoprotein(LDL)increased in group PRES,and the difference was statistically significant(P < 0.05);compared with group normal,TG increased and Apo-A1 ? HDL decreased in group preeclampsia,the difference was statistically significant(P < 0.05).5.Among liver and kidney function indexes,compared with the group normal,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma glutamyl transferase(GGT),lactate dehydrogenase(LDH),uric acid,urea and creatinine increased and albumin decreased in group PRES,the difference was statistically significant(P < 0.05);compared with the group preeclampsia,ALT,AST,LDH,uric acid,creatinine,albumin decreased in group PRES,the difference was statistically significant(P < 0.05).6.The ratio of PLT/MPV in the diagnosis of PRES by area under the curve(AUC)was 0.703(P < 0.01),the best diagnostic cut-off point was ?12.38,the sensitivity was46.88%,specificity was 87.89%.7.The incidence of placental abruption and HELLP syndrome in group PRES was higher than that in group preeclampsia,the difference was statistically significant(P <0.05);while in the incidence of postpartum hemorrhage,fetal distress,amniotic fluid,umbilical cord torsion,DIC,the difference was not statistically significant(P > 0.05).8.In the perinatal outcomes,compared with group preeclampsia,neonatal birth weight and length were lower in group PRES,while severe asphyxia rate was greater than the group preeclampsia,the difference was statistically significant(P < 0.05);And the difference of incidence of premature infants,mild neonatal asphyxia rate,gestational age and fetal death was not statistically significant(P > 0.05).Conclusion:There exists correlation between platelet parameters and coagulation index and PRES in pregnant women.PLT / MPV has certain predictive value for PRES,which benefits for early detection,early diagnosis and early treatment to improve perinatal maternal and fetal outcomes.