788: Mean platelet volume for intrapartum prediction of preeclampsia

Platelet activation and destruction is a well recognized feature of preeclampsia. We investigated whether mean platelet volume (MPV) measurements could distinguish preeclampsia (PE) from normal matched controls in the intrapartum period. MPV and other hematological measurements were compared retrospectively in PE and matched normal controls. In addition Hb, MCV and platelet count were obtained. Logistic regression analysis was used to determine the significant hematologic predictors of PE and to calculate an adjusted Odds Ratio (OR) for PE and severe PE based on MPV levels. There were 297 normal controls and 156 PE cases. In the latter group there were 60 (38.4%) mild PE cases, 84 (53.8%) with severe, 6 (7.1%) eclamptics and 6 (7.1%) were chronic hypertension with superimposed preeclampsia. The mean (SD) gestational age at MPV measurement was 37.3 (3.7) in controls vs. 36.2 (3.7) weeks in the study cases, p=0.002. MPV (SD) was 11.5 (1.3) fL in PE vs. 10.9 (1.1) fL in controls, (p < 0.001). The mean platelet volume was the only significant predictor of PE, OR (95% CI) = 4.51 (1.48, 13.74) and of severe PE, OR (95% CI) =6.21 (1.57, 24.6). Platelet count, in thousands / ml, was not a significant predictor of preeclampsia 230.8 (68.3) vs. 226.0 (63.3) in PE vs. controls, p=0.46. A limited number of control cases had creatinine levels measured. This was not significantly different between cases and controls. In a large study of PE cases, mean platelet volume was a significant intrapartum predictor of preeclampsia. It performed superiorly to routinely measured laboratory tests such as platelet count in detecting PE. MPV is routinely obtained on CBC studies and its utilization for assessing preeclampsia risk in a clinical setting should be evaluated.