Hemostasis in Pregnancy Induced Hypertension (PIH)

Abstract

Background: Pregnancy is a hypercoagulable state as the parturient is physiologically prepared against haemorrhage. Plasma fibrinogen level increases and platelet count decreases. Pregnancy induced Hypertension (PIH) is a syndrome complex of hypertension, oedema and proteinuria. In PIH, the physiological changes that occur in normal pregnancy are further aggravated and the woman is prone to develop Disseminated Intravascular Coagulation (DIC) which is a chief pathogenic factor in PIH. Objective: 1.To estimate platelet count and serum fibrinogen in normal pregnant women and women with PIH.2.To do bleeding time and clotting time in normal pregnant women and women with PIHand compare both. Material and methods: Two groups of pregnant women were involved. The first group (control) comprises normal pregnant women. The study group consists of pregnant women with PIH. Platelet count was done by direct method. Serum Fibrinogen was estimated by Rapid Turbidimetric method. Bleeding time was measured by Duke Method and Clotting time was measured by Wrights capillary tube method. Statistical analysis was done using appropriate student t test and SD. Results: In PIH group, platelet count is moderately reduced (Mean 1.72, P= 0.05) and bleeding time is prolonged (mean 117.45, P0.001), Serum fibrinogen level is reduced (mean 237.14, P 0.001) and clotting time is prolonged(mean 16.9,P 0.001). Conclusion: Pregnant women with PIH are more prone to develop coagulation abnormalities which may result in bleeding tendency. Hence, serial estimations of platelet count and bleeding time can be used to assess primary hemostatic function. Plasma fibrinogen level and clotting time measurement may be used to assess secondary hemostatic function.