Features of Morphometric Changes in Platelets and Red Blood Cells in Women with Various Forms of Hypertensive Disorders in the Third Trimester of Pregnancy

Background. Arterial hypertension during pregnancy is accompanied by pronounced changes in microcirculation and hemostasis in the system, the state of which is largely determined by the structural and functional properties of red blood cells and platelets. The study of quantitative and morphometric characteristics of blood cells will expand the existing understanding of their role in the pathogenesis of hypertensive disorders.

Aim of the research. To study the quantitative and morphometric indicators of red blood cells and platelets in pregnant women with various forms of hypertensive disorders, on the basis of which to develop an additional method for the diagnosis of preeclampsia.

Materials and methods. 237 women in the third trimester of pregnancy were examined. The main group (167 women) included patients with various forms of hypertensive disorders. The comparison group included 70 pregnant women without signs of hypertensive disorders. The characteristic of clinical and anamnestic data of the studied groups is given. A comparative analysis of the number and morphometric parameters of red blood cells and platelets was performed.

Results. With moderate and severe preeclampsia, a decrease in the level of red blood cells, hemoglobin and hematocrit was not accompanied by changes in red blood cell indices. In women with preeclampsia, regardless of the presence of chronic arterial hypertension, an increase in the average dry weight, average volume and degree of platelet anisocytosis was detected. In severe preeclampsia and preeclampsia with underlying of  chronic arterial hypertension, an increase in the number of large forms of platelets and their granulocytosis was revealed, and in addition, in severe cases of preeclampsia, a decrease in platelet level was noted.

Conclusions. Modern hematological analyzers make it possible to establish the nature of not only quantitative, but also morphometric changes in red blood cells and platelets, thereby complementing the existing understanding of the pathogenetic mechanisms underlying hypertensive disorders in pregnancy. Using average dry platelet mass and average blood pressure may be useful in diagnosing preeclampsia.

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