Some Selected Haematological Parameters of Patients with Pre-eclampsia and Eclampsia in Sokoto, Nigeria

Background: In Sokoto Nigeria, pre-eclampsia and eclampsia complicate 6% and 4.29% of pregnancies respectively. The occurrences of these diseases pose additional challenges to the haematopoietic system in pregnancy with resultant changes in haematological parameters. Documented changes include worsening of the dilutional anaemia of pregnancy, exaggerated neutrophilic leucocytosis and varying patterns of platelet count. However, the pattern of these changes have been shown to be influenced by nutritional status, presence of co-morbidities such as diabetes, renal diseases, haemoglobinopathies and infections as well as race and genetics. Aims and Objectives: This study aimed to determine haematocrit, white blood cell and platelet counts of patients with pre-eclampsia and eclampsia and compare same with normotensive pregnancy. Study Design: Cross-sectional comparative. Settings: Ninety-three pregnant women from two tertiary hospitals in Sokoto Northwest Nigeria were consecutively enrolled and grouped into three groups (pre-eclampsia, eclampsia and normotensive pregnancy) of 31 each. Materials and Methods: Structured proforma was used for clinical data capturing while automated full blood count using Nortek 3-part haematology analyser was conducted on venous blood. Leishmann stained peripheral blood smears were examined to validate the haemogram findings. Statistics: Data analysis was performed using SPSS version 21.0. Data distribution was ascertained using Shapiro-Wilk and summarized as means ± standard deviations. Comparison of means was performed using Anova or Independent samples t-test as appropriate. Results were presented in tables and statistical significance was set at p<0.05. Results: There were statistical significant differences in mean haematocrit (32.67±4.30 vs.29.74±6.08 vs.32.24±3.02; p=0.031), white blood cell count (8.02±2.11 vs. 15.92±7.11 vs. 4.61±2.78; p=0.001) and platelet count (212.19±59.01 vs. 203.10±64.86 vs. 266.23±65.29; p=0.001) of pre-eclamptics, eclamptics and normotensive pregnant women respectively. The highest mean MCV, MCH and RDW were recorded for eclampsia (89.35±5.80, 29.00±2.76 and.17.70±21.23) when compared with pre-eclampsia (87.95±10.68, 28.33±2.76 and.13.61±1.07) and normotensive pregnancy (81.29±4.66, 28.27±3.80 and.14.23±6.67) respectively. The following mean MPV, PDW, PCT and P-LCR were recorded for the pre-eclamptics (9.89±0.94, 20.47±25.54, 0.21±0.05 and 30.77±8.94), eclamptics (9.46±0.81, 15.52±1.02, 0.19±0.53 and 27.82±7.66) and normotensive pregnancy (9.36±0.64, 16.02±2.35, 0.25±0.06 and 19.23±5.93) respectively. Patients with severe pre-eclampsia had lower mean haematocrit (32.44±3.80 vs.33.23±5.56; p=0.649) and platelet count (187.00±45.62 vs. 273.78±39.76; p=0.001) but higher white blood cell count (8.06±2.11 vs.7.922.25; p=0.869) when compared to those with mild pre-eclampsia respectively. Similarly, the severe preeclamptics had higher mean MCV (88.01±10.51 vs.87.79±11.73; p=0.959), MCH (28.46±2.83 vs.28.01±2.71; p=0.692), MCHC (32.53±3.07 vs.32.11±2.88; p=0.727) and RDW (13.72±1.04 vs.13.34±1.15; p=0.380) when compared with mild pre-eclamptics respectively. Furthermore, higher mean MPV(10.07±0.97 vs.9.43±0.75; p=0.087) and P-LCR (31.92±9.37 vs.27.98±7.54; p=0.273) but lower mean PDW (15.89±0.87 vs.31.64±47.39; p=0.348) and PCT (0.19±0.05 vs.0.26±0.04; p=0.001) were recorded in severe pre-eclampsia when compared with mild pre-eclampsia respectively. Conclusions: We observed higher mean haematocrit values for pre-eclampsia when compared with eclampsia and normotensive pregnancies. We also observed normocytic-normochromic red cell picture, neutrophilic leucocytosis and consumptive thrombocytopaenia in patients with pre-eclampsia and eclampsia; reflecting challenges posed by these diseases on the haematopoietic system during pregnancy. Furthermore and in keeping with disease progression, some of these haematological changes were noted to be more pronounced in severe pre-eclampsia when compared with mild preeclampsia.