Evaluating Platelet Indices as Biomarkers in Gestational Hypertension: Clinical Implications and Future Perspectives - A Narrative Review

Background: Hypertensive disorders of pregnancy (HDPs), particularly gestational hypertension, remain major contributors to maternal and perinatal morbidity and mortality worldwide, with a disproportionate burden in low- and middle-income countries. Early identification of women at risk remains challenging because access to advanced diagnostic biomarkers is often limited in resource-constrained settings. Platelet indices generated from routine complete blood count (CBC) analysis have emerged as inexpensive and widely accessible biomarkers with potential utility for disease prediction and risk stratification. Objective: This narrative review critically evaluates the current evidence regarding the diagnostic and prognostic value of platelet indices. Methods: Literature search strategies were conducted using Medical Subject Headings (MeSH) and text keywords related to gestational and pregnancy-induced thrombocytopenia. The literature search was performed using PubMed, Google Scholar, EMBASE, and Web of Science Results: Current evidence suggests that increased MPV and PDW, together with reduced platelet count and PCT, are associated with disease severity and adverse maternal and fetal outcomes. The review should include a dedicated section discussing sources of heterogeneity (e.g., differences in analyzer types, cutoff values, gestational timing) and propose strategies for standardization, such as establishing gestational-age-specific reference ranges. Conclusion: Platelet indices represent promising, readily available biomarkers that may complement the assessment and monitoring of gestational hypertension, particularly in resource-constrained settings. Objective: This narrative review critically evaluates the current evidence regarding the diagnostic and prognostic value of platelet indices .