Platelet changes and subsequent development of pre-eclampsia and fetal growth restriction in women with abnormal uterine artery Doppler screening.
OBJECTIVE
To investigate whether, in women with abnormal uterine artery Doppler, platelet volume and function will identify a subgroup of women at increased risk of pre-eclampsia and intrauterine growth restriction and whether in-vitro platelet aggregation precedes the onset of clinical disease.


METHODS
Platelet number, volume and aggregation induced by collagen or adenosine 5'-diphosphate were evaluated in 16 non-pregnant controls, 29 pregnant women with normal uterine artery Doppler and 31 pregnant women with abnormal Doppler, hence at risk of pre-eclampsia and intrauterine growth restriction at 23 weeks. Outcome of pregnancy was recorded in each case.


RESULTS
Twelve women in the group with abnormal uterine artery Doppler subsequently developed pre-eclampsia and/or intrauterine growth restriction. All women with normal uterine artery Doppler had a normal pregnancy outcome. No differences in platelet count or in vitro platelet aggregation induced by collagen were observed between the groups. Mean platelet volume was greater in those with abnormal Doppler who had intrauterine growth restriction or normal pregnancy outcome compared with normal Doppler (10.3 and 10.3 vs. 9.4 fL, P = 0.004 and P = 0.01, respectively). Aggregation induced by adenosine diphosphate was higher in women with abnormal Doppler who developed pre-eclampsia or intrauterine growth restriction compared with those with normal outcomes (66.5 and 66.5 vs. 21%, P = 0.02, P = 0.03, respectively).


CONCLUSIONS
Women with abnormal uterine artery Doppler at 23 weeks show alterations in mean platelet volume and platelet function that relate to subsequent adverse outcome.
Missfelder-Lobos
H
H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital and The Wolfson Institute for Biomedical Research, University College London, London, UK. milobh@medizin.uni-leipzig.de
Teran
E
E
Lees
C
C
Albaiges
G
G
Nicolaides
K H
KH
D001158:Arteries / Q000000981:diagnostic imaging*; D001792:Blood Platelets / Q000166:cytology*; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D010974:Platelet Aggregation / Q000502:physiology; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging