Platelet Count and Mean Platelet Volume in First Trimester are the Predictors of Preterm Premature Rupture of Membranes

Background: Preterm Premature Rupture of Membranes (PPROM) complicates up to
3% of pregnancies and is associated with 30-40% of preterm birth..

Objective: To find out the values of Platelet Count (PC) and Mean Platelet Volume
(MPV) during first trimester of pregnancy to predict preterm premature
rupture of membranes (PPROM).

Methods: This prospective cohort study was conducted on 75 study subjects in
Department of Fetomaternal Medicine and Obstetrics and
Gynaecology, BSMMU, after taking approval from Institutional Review
Board (IRB). Non-random purposive sampling technique was followed.
After taking consent and matching eligibility criteria, data were
collected from subjects on variables of interest using the structured
designed by interview, observation, clinical examination and
haematological investigation PC and MPV of subjects at 11 – 13 weeks
of gestation. Levels of PC and MPV were documented, and participants
were followed until delivery and also advised to report immediately if
they experienced symptoms of PPROM. During the follow up, two
participants were dropped out. Data were recorded on separate sheets
for each participant and analyzed using SPSS 22.0 software.

Result: In comparison with non PPROM, PPROM had significantly increasedthe
level of PC and significantly decreased level of MPV in the first trimester
of PPROM. The cut off value of the MPV ≤8 fL and PC ≥294,000/cu.mm.
Sensitivity and Specificity of MPV 77.8% and 93.8% and Sensitivity and
Specificity of PC were 66.7 % and 70.3%. Subjects with Platelet Count
(PC) ≥294000/cu.mm had 3.84 times higher risk to develop PPROM and
MPV ≤8fL had 19.73 times the higher risk to have PPROM. The overall
accuracy of MPV for detecting PPROM was found to be superior to the
Platelet Count (PC).

Conclusion:
Low MPV and high PC at first trimester of pregnancy are predictors of
PPROM.