Volumen plaquetario medio en el segundo trimestre del embarazo como predictor de preeclampsia
Mean platelet volume in the second trimester of pregnancy as Predictor of preeclampsia
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Reyna-Villasmil, E., Mejía Montilla, J., Torres Cepeda, D., Reyna-Villasmil, N., & Rondón Tapia, M. (2018). Volumen plaquetario medio en el segundo trimestre del embarazo como predictor de preeclampsia. Revista Repertorio De Medicina Y Cirugía, 27(1), 7–12. https://doi.org/10.31260/RepertMedCir.v27.n1.2018.125
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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Objetivo: establecer la utilidad de los valores del volumen plaquetario medio en el segundo trimestre del embarazo como predictor del desarrollo de preeclampsia. Materiales y métodos: investigación prospectiva en 504 pacientes nulíparas con embarazos simples entre 17 y 20 semanas que acudieron a la consulta prenatal. Se evaluaron las características generales, valores del volumen plaquetario medio y eficacia pronóstica. Resultados: los casos fueron 41 embarazadas que desarrollaron preeclampsia (grupo A) y 463 embarazadas consideradas controles (grupo B). No se encontraron diferencias estadísticas significativas en la edad materna, edad gestacional y presión arterial sistólica y diastólica al momento de la realización de la ecografía (p = ns). La edad gestacional al momento del diagnóstico de preeclampsia en el grupo A fue de 35,0 +/- 3,2 semanas. Se encontraron diferencias estadísticamente significativas en los valores del volumen plaquetario medio entre el grupo A (10,15 +/- 0,57 fL) y el B (9,65 +/- 0,61 fL; p < 0,0001). Un valor de corte de 9,50 fL presentó una cifra por debajo de la curva de 0,714 y tiene sensibilidad de 85,4%, especificidad del 40,6%, valor predictivo positivo del 11,3% y valor predictivo negativo del 96,5%. Conclusión: los valores del volumen plaquetario medio en el segundo trimestre no son útiles en la predicción del desarrollo de preeclampsia.
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2. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(1022):999-1011. doi: 10.1016/S00-6736(15)00070-7.
3. Patil R, Ghosh K, Shetty S. Could procoagulant cell-derived microparticles have a more crucial role in pregnancy complications rather than exosomes? Am J Obstet Gynecol. 2016;214(6):765-6. doi: 10.1016/j.ajog.2016.02.014.
4. Yüksel Kalkan G, Gür M, Baykan AO, Uçar H, Elbasan Z, Sahin DY, Koç M, Börekçi A, Çaylı M. Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anatol J Cardiol. 2015;15(9):753-8. doi: 10.5152/akd.2014.5576.
5. Calvert SM, Tuffnell DJ, Haley J. Poor predictive value of platelet count, mean platelet volume and serum urate in hypertension in pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;64(2):179-84.
6. Dundar O, Yoruk P, Tutuncu L, Erikci AA, Muhcu M, Ergur AR, Atay V, Mungen E. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008;28(11):1052-6. doi: 10.1002/ pd.2126.
7. Dogan K, Guraslan H, Senturk MB, Helvacioglu C, Idil S, Ekin M. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy. 2015;34(4):434- 442.
8. Yavuzcan A, Caglar M, Ustün Y, Dilbaz S, Ozdemir I, Yildiz E, Ozbilgeç S, Kumru S. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197-203.
9. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32. doi: 10.1016/j.preghy.2016.12.002.
10. Kashanian M, Hajjaran M, Khatami E, Sheikhansari N. Evaluation of the value of the first and third trimester maternal mean platelet volume (MPV) for prediction of pre-eclampsia. Pregnancy Hypertens. 2013;3(4):222-6. doi: 10.1016/j.preghy.2013.06.001.
11. AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag. 2016;12:477-480.
12. Kanat-Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil- Koken G, Yilmazer M. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014;40(7):1840-5. doi: 10.1111/jog.12433.
13. Vilchez G, Londra L, Hoyos LR, Sokol R, Bahado-Singh R. Intrapartum mean platelet volume is not a useful predictor of new-onset delayed postpartum pre-eclampsia. Int J Gynaecol Obstet. 2015;131(1):59-62. doi: 10.1016/j.ijgo.2015.04.037.
14. Fuentes F, Palomo I, Fuentes E. Platelet oxidative stress as a novel target of cardiovascular risk in frail older people. Vascul Pharmacol. 2017;93-95:14-19. doi: 10.1016/j.vph.2017.07.003.
15. Schmoeller D, Picarelli MM, Paz Munhoz T, Poli de Figueiredo CE, Staub HL. Mean Platelet Volume and Immature Platelet Fraction in Autoimmune Disorders. Front Med (Lausanne). 2017;4:146. doi: 10.3389/fmed.2017.00146.
16. Everett TR, Garner SF, Lees CC, Goodall AH. Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies. Thromb Haemost. 2014;111(6):1177-9. doi: 10.1160/TH13-09-0746.
17. Jodkowska A, Martynowicz H, Kaczmarek-Wdowiak B, Mazur G. Thrombocytopenia in pregnancy - pathogenesis and diagnostic approach. Postepy Hig Med Dosw (Online). 2015;69:1215-21.
18. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-8.
19. Tynngård N, Wallstedt M, Södergren AL, Faxälv L, Ramström S. Platelet adhesion changes during storage studied with a novel method using flow cytometry and protein-coated beads. Platelets. 2015;26(2):177-85. doi: 10.3109/09537104.2014.891728.
20. Li A, Chen J, Liang ZH, Cai J, Cai HH, Chen M. Comparison of ultrastructural and nanomechanical signature of platelets from acute myocardial infarction and platelet activation. Biochem Biophys Res Commun. 2017;486(2):245-251. doi: 10.1016/j. bbrc.2017.03.009.
21. Piazze J, Gioia S, Maranghi L, Anceschi M. Mean platelet and red blood cell volume measurements to estimate the severity of hypertension in pregnancy. J Perinat Med. 2006;34(3):246-7.
22. Myatt L, Clifton RG, Roberts JM, Spong CY, Hauth JC, Varner MW, Thorp JM Jr, Mercer BM, Peaceman AM, Ramin SM, Carpenter MW, Iams JD, Sciscione A, Harper M, Tolosa JE, Saade G, Sorokin Y, Anderson GD; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. First-trimester prediction of preeclampsia in nulliparous women at low risk. Obstet Gynecol. 2012;119(6):1234-42. doi: 10.1097/AOG.0b013e3182571669.
23. Walker JJ, Cameron AD, Bjornsson S, Singer CR, Fraser C. Can platelet volume predict progressive hypertensive disease in pregnancy? Am J Obstet Gynecol. 1989;161(3):676-9.
24. Lancé MD, Sloep M, Henskens YM, Marcus MA. Mean platelet volume as a diagnostic marker for cardiovascular disease: drawbacks of preanalytical conditions and measuring techniques. Clin Appl Thromb Hemost. 2012;18(6):561-8. doi: 10.1177/1076029612458147
2. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(1022):999-1011. doi: 10.1016/S00-6736(15)00070-7.
3. Patil R, Ghosh K, Shetty S. Could procoagulant cell-derived microparticles have a more crucial role in pregnancy complications rather than exosomes? Am J Obstet Gynecol. 2016;214(6):765-6. doi: 10.1016/j.ajog.2016.02.014.
4. Yüksel Kalkan G, Gür M, Baykan AO, Uçar H, Elbasan Z, Sahin DY, Koç M, Börekçi A, Çaylı M. Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anatol J Cardiol. 2015;15(9):753-8. doi: 10.5152/akd.2014.5576.
5. Calvert SM, Tuffnell DJ, Haley J. Poor predictive value of platelet count, mean platelet volume and serum urate in hypertension in pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;64(2):179-84.
6. Dundar O, Yoruk P, Tutuncu L, Erikci AA, Muhcu M, Ergur AR, Atay V, Mungen E. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008;28(11):1052-6. doi: 10.1002/ pd.2126.
7. Dogan K, Guraslan H, Senturk MB, Helvacioglu C, Idil S, Ekin M. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy. 2015;34(4):434- 442.
8. Yavuzcan A, Caglar M, Ustün Y, Dilbaz S, Ozdemir I, Yildiz E, Ozbilgeç S, Kumru S. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197-203.
9. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32. doi: 10.1016/j.preghy.2016.12.002.
10. Kashanian M, Hajjaran M, Khatami E, Sheikhansari N. Evaluation of the value of the first and third trimester maternal mean platelet volume (MPV) for prediction of pre-eclampsia. Pregnancy Hypertens. 2013;3(4):222-6. doi: 10.1016/j.preghy.2013.06.001.
11. AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag. 2016;12:477-480.
12. Kanat-Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil- Koken G, Yilmazer M. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014;40(7):1840-5. doi: 10.1111/jog.12433.
13. Vilchez G, Londra L, Hoyos LR, Sokol R, Bahado-Singh R. Intrapartum mean platelet volume is not a useful predictor of new-onset delayed postpartum pre-eclampsia. Int J Gynaecol Obstet. 2015;131(1):59-62. doi: 10.1016/j.ijgo.2015.04.037.
14. Fuentes F, Palomo I, Fuentes E. Platelet oxidative stress as a novel target of cardiovascular risk in frail older people. Vascul Pharmacol. 2017;93-95:14-19. doi: 10.1016/j.vph.2017.07.003.
15. Schmoeller D, Picarelli MM, Paz Munhoz T, Poli de Figueiredo CE, Staub HL. Mean Platelet Volume and Immature Platelet Fraction in Autoimmune Disorders. Front Med (Lausanne). 2017;4:146. doi: 10.3389/fmed.2017.00146.
16. Everett TR, Garner SF, Lees CC, Goodall AH. Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies. Thromb Haemost. 2014;111(6):1177-9. doi: 10.1160/TH13-09-0746.
17. Jodkowska A, Martynowicz H, Kaczmarek-Wdowiak B, Mazur G. Thrombocytopenia in pregnancy - pathogenesis and diagnostic approach. Postepy Hig Med Dosw (Online). 2015;69:1215-21.
18. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-8.
19. Tynngård N, Wallstedt M, Södergren AL, Faxälv L, Ramström S. Platelet adhesion changes during storage studied with a novel method using flow cytometry and protein-coated beads. Platelets. 2015;26(2):177-85. doi: 10.3109/09537104.2014.891728.
20. Li A, Chen J, Liang ZH, Cai J, Cai HH, Chen M. Comparison of ultrastructural and nanomechanical signature of platelets from acute myocardial infarction and platelet activation. Biochem Biophys Res Commun. 2017;486(2):245-251. doi: 10.1016/j. bbrc.2017.03.009.
21. Piazze J, Gioia S, Maranghi L, Anceschi M. Mean platelet and red blood cell volume measurements to estimate the severity of hypertension in pregnancy. J Perinat Med. 2006;34(3):246-7.
22. Myatt L, Clifton RG, Roberts JM, Spong CY, Hauth JC, Varner MW, Thorp JM Jr, Mercer BM, Peaceman AM, Ramin SM, Carpenter MW, Iams JD, Sciscione A, Harper M, Tolosa JE, Saade G, Sorokin Y, Anderson GD; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. First-trimester prediction of preeclampsia in nulliparous women at low risk. Obstet Gynecol. 2012;119(6):1234-42. doi: 10.1097/AOG.0b013e3182571669.
23. Walker JJ, Cameron AD, Bjornsson S, Singer CR, Fraser C. Can platelet volume predict progressive hypertensive disease in pregnancy? Am J Obstet Gynecol. 1989;161(3):676-9.
24. Lancé MD, Sloep M, Henskens YM, Marcus MA. Mean platelet volume as a diagnostic marker for cardiovascular disease: drawbacks of preanalytical conditions and measuring techniques. Clin Appl Thromb Hemost. 2012;18(6):561-8. doi: 10.1177/1076029612458147
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