Haemostatic Function and Predictive Values for Pre-Eclampsia Severity of Pregnant Women in a Rural West African Town

Abstract

Introduction: This study aimed to assess hemostatic function in preeclampsia using selected coagulation indices and to determine whether these indices are predictive of preeclampsia severity in a rural West African population. Methods: A hospital-based case-control study was conducted involving 65 women with preeclampsia as the test group and 65 age-, trimester-, and parity-matched normotensive, non-proteinuric pregnant Black women as controls. The preeclamptic group was classified as having mild or severe disease according to the American College of Obstetricians and Gynecologists (ACOG) criteria. The coagulation parameters assessed included platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), plasminogen activator inhibitor type-1 (PAI-1), fibrinogen, D-dimer, and mean platelet volume (MPV). Results: Among the preeclamptic participants, 34(52.9%) had mild and 31(47.7%) had severe preeclampsia. In the second trimester, median plasma fibrinogen and D-dimer levels were significantly higher in the preeclamptic group compared to controls: 298.4 (217–408) mg/dL vs. 207.4 (134–256) mg/dL for fibrinogen (p<0.001), and 589.4 (278–1002) ng/mL vs. 102.0 (78–178) ng/mL for D-dimer (p<0.001). Mean PAI-1 levels were also elevated in preeclamptic women compared to controls in both the second trimester (6.41±2.4 vs. 4.73±1.5 ng/mL; p<0.001) and third trimester (10.61±2.6 vs. 7.21±1.6 ng/mL; p<0.001). Receiver Operating Characteristic (ROC) curve analysis indicated that third-trimester levels of PAI-1, fibrinogen, and D-dimer were significant predictors of preeclampsia severity (p < 0.05). Conclusion: This study confirms prior findings of a progressive increase in fibrinogen, PAI-1, and D-dimer levels during pregnancy, with significantly higher levels observed in women with preeclampsia. These coagulation indices, particularly in the third trimester, may serve as useful biomarkers for predicting the clinical severity of preeclampsia.