Haematological Parameters, Coagulation Profile and Serum Lactate Dehydrogenase in Women with Pregnancy Induced Hypertension versus Normotensive Pregnant Women: A Case-control Study

Introduction: Pregnancy-Induced Hypertension (PIH) is the most common disorder of pregnancy, affecting approximately 5-7% of pregnancies and it is a significant cause of maternal and foetal morbidity and mortality. In a proportion of these patients, the risk to the mother can be substantial, including the possible development of Microangiopathic Haemolytic Anaemia (MAHA). Altered haemogram and coagulation abnormalities, such as anaemia, thrombocytopenia, the presence of schistocytes and deranged Prothrombin Time (PT) and activated Partial Thromboplastin Time (APTT) values, are hallmarks of these patients. Aim: To compare haematological and coagulation parameters, as well as serum Lactate Dehydrogenase (LDH) levels, in normal pregnant women and those with PIH. Materials and Methods: This was a case-control study in which 100 patients were analysed in a tertiary care centre attached to a University Medical College in western India over two years. Complete Blood Count (CBC) with peripheral blood smear, PT, aPTT and serum LDH were performed on patients with PIH (50) and normal pregnancies (50). The data were analysed using Statistical Package for the Social Sciences (SPSS) version 25.0 software. For qualitative data, various rates, ratios and percentages were calculated. Chi-square test was used to find associations between two or more attributes. For quantitative data, Mean±SD was calculated. The unpaired t-test was utilised to compare the two independent groups for the data variables. A p-value of <0.05 was considered significant. Results: The platelet count was decreased in 48 out of 50 PIH patients (96%), while PT and aPTT were increased in all 50 patients with PIH. Serum LDH values were elevated in 16 patients with PIH (32%). The p-value was found to be <0.0001 in women with Preeclampsia (PE) and Eclampsia (E) compared to normal pregnant women for platelet count, PT, APTT and serum LDH. Only four PIH patients showed the presence of schistocytes on the peripheral smear. Conclusion: Patients with PIH exhibited low platelet counts, high PT/APTT values and elevated serum LDH levels compared to normal pregnant patients. PIH and Disseminated Intravascular Coagulation (DIC) can present with overlapping features, such as thrombocytopenia and abnormal liver function tests, but they differ in clinical context and severity of coagulation abnormalities.