Coagulation and hematological variations in pregnancy: A cross-sectional study on hypertensive and normotensive females

Objective: To evaluate and compare coagulation and hematological parameters in hypertensive and normotensive pregnant women. Methods: This present cross-sectional study was carried out in the Departments of Pathology and Obstetrics & Gynaecology at Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, India from September 2023 to March 2025. Hematological parameters [platelet count, mean platelet volume (MPV), platelet distribution width (PDW)] were analyzed using an automated hematology analyzer, while coagulation parameters [prothrombin time (PT)/international normalised ratio, activated partial thromboplastin time (aPTT), and D -dimer] were assessed by standard automated assays. Results were compared between normotensive and hypertensive groups and correlated with disease severity. Results: The study included 212 antenatal females, with 106 normotensive pregnant women and 106 hypertensive women. Hypertensive women include cases of gestational hypertension ( n =55); mild preeclampsia ( n =39), and severe preeclampsia ( n =12). A significant progressive decrease in platelet count and significant increases in MPV, PDW, PT, aPTT, and D -dimer levels were associated with increasing severity of pregnancy-induced hypertension ( P <0.001). Women with severe preeclampsia had the lowest mean platelet counts and the highest coagulation parameter values compared to women with gestational hypertension, mild preeclampsia, and normotensive pregnancies. These findings indicate enhanced platelet activation, endothelial dysfunction, and activation of the coagulation-fibrinolytic system with worsening disease severity. Conclusions: Significant hematologic and coagulation abnormalities were present in women with pregnancy-induced hypertension. For better maternal-fetal outcomes and early management, routine monitoring is essential.