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Does platelet aggregation have any importance in fetal growth restriction pregnancies?
, 2, 1, 1, 2, 1, 1
Affiliations- Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland
- Students Scientific Association by the Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poland
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Abstract
Objectives: The aim of the study was to evaluate platelet (PLT) concentration, mean platelet volume (MPV), PLT aggregation and its velocity in pregnancy complicated with fetal growth restriction (FGR) and to analyze the PLT aggregation according to the gestational age and Doppler velocimetry.
Material and methods: The study group included 29 pregnant women diagnosed with FGR. The control group-consisted of 27 females in uncomplicated pregnancy. Then both groups were divided according to the gestational week (< and ≥ 36 weeks) and Doppler velocimetry results. The adenosine diphosphate (ADP) induced PLT aggregation was performed with the help of the electrical impedance.
Results: There was a significant positive correlation between gestational age and PLT aggregation and between gestational age and velocity of PLT aggregation in FGR. Patients with FGR ≥ 36 weeks of gestation had 73% higher PLT aggregation than control group. Within the FGR group, the PLT aggregation was 135% higher in pregnancies ≥ 36 weeks as compared to < 36 weeks of gestation. In FGR pregnancies ≥ 36 weeks with impaired flow in both uterine arteries (UtA), 2.3-fold higher PLT aggregation was found as compared to FGR patients with normal flow or abnormal flow in one UtA.
Conclusions: The increased PLT aggregation in FGR is related to gestational week and occurs in pregnancies ≥ 36 weeks of gestation. The PLT hyperaggregability in growth-restricted pregnancies is associated with abnormal Doppler velocimetry in both UtA, comparing to patients with altered blood flow in one UtA or normal pulsatility index in both UtA, suggesting the PLT activation due to impaired uteroplacental circulation.
Abstract
Objectives: The aim of the study was to evaluate platelet (PLT) concentration, mean platelet volume (MPV), PLT aggregation and its velocity in pregnancy complicated with fetal growth restriction (FGR) and to analyze the PLT aggregation according to the gestational age and Doppler velocimetry.
Material and methods: The study group included 29 pregnant women diagnosed with FGR. The control group-consisted of 27 females in uncomplicated pregnancy. Then both groups were divided according to the gestational week (< and ≥ 36 weeks) and Doppler velocimetry results. The adenosine diphosphate (ADP) induced PLT aggregation was performed with the help of the electrical impedance.
Results: There was a significant positive correlation between gestational age and PLT aggregation and between gestational age and velocity of PLT aggregation in FGR. Patients with FGR ≥ 36 weeks of gestation had 73% higher PLT aggregation than control group. Within the FGR group, the PLT aggregation was 135% higher in pregnancies ≥ 36 weeks as compared to < 36 weeks of gestation. In FGR pregnancies ≥ 36 weeks with impaired flow in both uterine arteries (UtA), 2.3-fold higher PLT aggregation was found as compared to FGR patients with normal flow or abnormal flow in one UtA.
Conclusions: The increased PLT aggregation in FGR is related to gestational week and occurs in pregnancies ≥ 36 weeks of gestation. The PLT hyperaggregability in growth-restricted pregnancies is associated with abnormal Doppler velocimetry in both UtA, comparing to patients with altered blood flow in one UtA or normal pulsatility index in both UtA, suggesting the PLT activation due to impaired uteroplacental circulation.
Keywords
fetal growth restriction; platelet aggregation; platelet concentration; mean platelet volume; velocity of platelet aggregation; ADP-induced platelet aggregation
About this articleTitle
Does platelet aggregation have any importance in fetal growth restriction pregnancies?
Journal
Issue
Article type
Research paper
Pages
968-974
Published online
2022-03-22
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3501
Article views/downloads
491
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(12):968-974.
Keywords
fetal growth restriction
platelet aggregation
platelet concentration
mean platelet volume
velocity of platelet aggregation
ADP-induced platelet aggregation
Authors
Natalia Misan
Bartosz Burchardt
Przemyslaw Korszun
Katarzyna Kapska
Joanna Kapska
Katarzyna Kawka-Paciorkowska
Mariola Ropacka-Lesiak
References (34)- Abdulkader ZM, Ur Rahman S, Nimeri N. The incidence of low birth weight and intrauterine growth restriction in relationship to maternal ethnicity and gestational age at birth - A PEARL study analysis from the State of Qatar. Qatar Med J. 2012; 2012(2): 32–37.
- Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr. 2016; 10: 67–83.
- Ropacka-Lesiak M. Wewnątrzmaciczne ograniczenie wzrastania płodu (IUGR). Perinat Neonat Ginek. 2014; 7(2): 112–116.
- Ropacka-Lesiak M. Wewnątrzmaciczne ograniczenie wzrastania płodu (FGR). In: Brębowicz GH, Ropacka-Lesiak M, Wielgoś M, Paszkowski T. ed. Sytuacje kliniczne w położnictwie. PZWL, Warszawa 2016: 135–138.
- Müllers SM, Burke N, Flood K, et al. Altered Platelet Function in Intrauterine Growth Restriction: A Cause or a Consequence of Uteroplacental Disease? Am J Perinatol. 2016; 33(8): 791–799.
- Chandra S, Tripathi AK, Mishra S, et al. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus. 2012; 28(3): 144–146.
- Reese JA, Peck JD, Deschamps DR, et al. Platelet Counts during Pregnancy. N Engl J Med. 2018; 379(1): 32–43.
- Missfelder-Lobos H, Teran E, Lees C, et al. Platelet changes and subsequent development of pre-eclampsia and fetal growth restriction in women with abnormal uterine artery Doppler screening. Ultrasound Obstet Gynecol. 2002; 19(5): 443–448.
- Yau JW, Teoh H, Verma S. Endothelial cell control of thrombosis. BMC Cardiovasc Disord. 2015; 15: 130.
- Quaranta M, Erez O, Mastrolia SA, et al. The physiologic and therapeutic role of heparin in implantation and placentation. PeerJ. 2015; 3: e691.
- Rolnik DL, Wright D, Poon LCY, et al. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet Gynecol. 2017; 50(4): 492–495.
- Tan MY, Poon LC, Rolnik DL, et al. Prediction and prevention of small-for-gestational-age neonates: evidence from SPREE and ASPRE. Ultrasound Obstet Gynecol. 2018; 52(1): 52–59.
- Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014; 36(2): 86–98.
- Kwiatkowski S, Torbe A, Borowski D, et al. Polish Society of Gynecologists and Obstetricians Recommendations on diagnosis and management of fetal growth restriction. Ginekol Pol. 2020; 91(10): 634–643.
- Sibbing D, Braun S, Jawansky S, et al. Assessment of ADP-induced platelet aggregation with light transmission aggregometry and multiple electrode platelet aggregometry before and after clopidogrel treatment. Thromb Haemost. 2008; 99(1): 121–126.
- Siller-Matula JM, Spiel AO, Lang IM, et al. Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am Heart J. 2009; 157(1): 148.e1–148.e5.
- Scharbert G, Auer A, Kozek-Langenecker S. Evaluation of the Platelet Mapping Assay on rotational thromboelastometry ROTEM. Platelets. 2009; 20(2): 125–130.
- Siller-Matula JM, Christ G, Lang IM, et al. Multiple electrode aggregometry predicts stent thrombosis better than the vasodilator-stimulated phosphoprotein phosphorylation assay. J Thromb Haemost. 2010; 8(2): 351–359.
- Belo L, Santos-Silva A, Rumley A, et al. Elevated tissue plasminogen activator as a potential marker of endothelial dysfunction in pre-eclampsia: correlation with proteinuria. BJOG. 2002; 109(11): 1250–1255.
- Bielecki DA, Tomasiak M, Stelmach H, et al. Morphologic parameters of blood platelets and activity NA+/H+ (NHE-1) exchanger in normal pregnancy and pregnancy complicated with preeclampsia. Ginekol Pol. 2003; 74 (10): 1060-5. Indexed in Pubmed. ; 14669395.
- Kashanian M, Hajjaran M, Khatami E, et al. Evaluation of the value of the first and third trimester maternal mean platelet volume (MPV) for prediction of pre-eclampsia. Pregnancy Hypertens. 2013; 3(4): 222–226.
- Kanat-Pektas M, Yesildager U, Tuncer N, et al. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014; 40(7): 1840–1845.
- Temur M, Taşgöz FN, Çift T, et al. Role of platelet indices in prediction of preeclampsia. Ginekol Pol. 2021; 92(11): 792–796.
- Ureyen I, Ozyuncu O, Sahin-Uysal N, et al. Relationship of maternal mean platelet volume with fetal Doppler parameters and neonatal complications in pregnancies with and without intrauterine growth restriction. J Matern Fetal Neonatal Med. 2017; 30(4): 471–474.
- Koroglu N, Tayyar A, Tola E, et al. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume and plateletcrit in isolated intrauterine growth restriction and prediction of being born small for gestational age. Archives of Medical Science - Civilization Diseases. 2017; 2(1): 139–144.
- Burke N, Flood K, Murray A, et al. Platelet reactivity changes significantly throughout all trimesters of pregnancy compared with the nonpregnant state: a prospective study. BJOG. 2013; 120(13): 1599–1604.
- Pimentel AML, Pereira NR, Costa CA, et al. L-arginine-nitric oxide pathway and oxidative stress in plasma and platelets of patients with pre-eclampsia. Hypertens Res. 2013; 36(9): 783–788.
- Norris LA, Sheppard BL, Burke G, et al. Platelet activation in normotensive and hypertensive pregnancies complicated by intrauterine growth retardation. Br J Obstet Gynaecol. 1994; 101(3): 209–214.
- Müllers SM, Burke N, Flood K, et al. Altered platelet function in intrauterine growth restriction: a cause or a consequence of uteroplacental disease? Am J Perinatol. 2016; 33(8): 791–799.
- Paidas MJ, Haut MJ, Ludomirsky A, et al. 374 the relationship between fetal platelet function in the third trimester and umbilical doppler velocimetry. American Journal of Obstetrics and Gynecology. 1992; 166(1): 379.
- Everett TR, Mahendru A, Goodall AH, et al. OP16.09: Relationship between uterine artery Doppler PI and platelet aggregation in women at risk of preeclampsia. Ultrasound in Obstetrics & Gynecology. 2011; 38(S1): 103–103.
- Ureyen I, Ozyuncu O, Sahin-Uysal N, et al. Relationship of maternal mean platelet volume with fetal Doppler parameters and neonatal complications in pregnancies with and without intrauterine growth restriction. J Matern Fetal Neonatal Med. 2017; 30(4): 471–474.
- Piazze J, Gioia S, Cerekja A, et al. Doppler velocimetry alterations related to platelet changes in third trimester pregnancies. Platelets. 2007; 18(1): 11–15.
- Gioia S, Piazze J, Anceschi MM, et al. Mean platelet volume: association with adverse neonatal outcome. Platelets. 2007; 18(4): 284–288.
