| Objective:The purpose of this study was to investigate the expression of coagulation and platelet parameters in blood of normotensive,normotensive hypertensive pregnant women and hypertensive disorder complicating pregnancy,and further define whether the normal high blood pressure pregnant women need to be classified as hypertensive disorder complicating pregnancy for special management.Methods:The pregnant women who received regular birth examination in Qingdao Municipal Hospital hospital from December 2021 to December 2022 were selected,and their blood pressure was measured according to the Chinese Guidelines for Blood Pressure Measurement.89 cases were divided into the hypertensive disorders in pregnancy group(hypertensive group,meeting the diagnostic criteria for hypertensive disorders in pregnancy in the Obstetrics and Gynaecology(9th edition)),normal hypertensive pregnant women group 41 cases(normal high value group,systolic blood pressure of 130-139 mm Hg and/or diastolic blood pressure of 80-89 mm Hg on at least 2non-same days),and 65 cases in the normotensive group(normal group,systolic blood pressure < 130 mm Hg and diastolic blood pressure < 80 mm Hg).(1)The general data of the three groups were compared(age,gestational time,birth time,gestational age,pre-pregnancy body mass index(BMI),gestational weight gain(GWG),systolic blood pressure and diastolic blood pressure);(2)The levels of coagulation indexes(thrombin time,prothrombin time,activated partial thromboplastin time and fibrinogen)at 32～34weeks of pregnant women in the three groups were detected in the laboratory and compared in pairs among the three groups;(3)The platelet parameters(platelet count,plateletcrit,platelet volume distribution width and mean platelet volume)at 32～34weeks of pregnant women in the three groups were detected in the laboratory and compared in pairs;(4)Logistic regression analysis was carried out on variables with statistically significant differences in univariate analysis to analyze independent risk factors for the onset of pregnancy-induced hypertension,and ROC curve was drawn to explore the predictive value of coagulation indexes and platelet parameters in the onset of pregnancy-induced hypertension.Results:(1)The differences in pre-pregnancy BMI,GWG,systolic blood pressure and diastolic blood pressure were statistically significant(P < 0.05);the differences in pre-pregnancy BMI,GWG,systolic blood pressure and diastolic blood pressure were statistically significant(P < 0.05)in the normal high value group compared with the normal group,and the differences in gestational week were not statistically significant(P > 0.05).(2)Comparison of coagulation indexes between the three groups showed that the differences in fibrinogen and activated partial thromboplastin time between the three groups were not statistically significant(P > 0.05);the value of prothrombin time in the hypertensive group was significantly lower than that in the normal high value group and the normal group,and the difference was statistically significant(P < 0.05),and the difference between the normal high value group and the normal group was not statistically significant(P > 0.05);the value of prothrombin time in the hypertensive group was significantly higher than that in the normal high value group.The difference was statistically significant(P < 0.05),but the difference was not statistically significant(P > 0.05)when comparing the normal high value group with the normal group.(3)Comparison of platelet parameters between the three groups showed that: the difference in platelet pressure volume between the three groups was not statistically significant(P > 0.05);the platelet count in the hypertensive group was significantly lower than that in the normal high value group and the normal group,and the difference was statistically significant(P < 0.05),and the difference between the normal high value group and the normal group was not statistically significant(P > 0.05);the mean platelet volume and platelet volume distribution width in the hypertensive group were significantly higher than those in the normal high value group.The difference was statistically significant(P < 0.05),and the difference was not statistically significant(P > 0.05)when comparing the normal high value group with the normal group.(4)By binary logistic regression analysis: platelet volume distribution width and prothrombin time were independent risk factors for the development of hypertensive disorders in pregnancy(P < 0.01)and was positively correlated with the development of hypertensive disorders in pregnancy;prothrombin time was independent risk factor for the development of hypertensive disorders in pregnancy(P < 0.01),which was negatively correlated with the development of hypertensive disorders in pregnancy.(5)According to ROC curve,the AUC of mean platelet volume,prothrombin time and thrombin time for predicting hypertensive diseases in pregnancy were 0.701,0.617 and 0.719,respectively,and the optimal cut-off values were 11.05 fl,11.55 S and 16.75 S,respectively.In the combined prediction,the AUC of mean platelet volume +prothrombin time,mean platelet volume + thrombin time,prothrombin time + thrombin time were 0.672,0.733 and 0.725,respectively.Combined,the three predicted an AUC of 0.800 for HDP.Conclusions:1.The coagulation index and platelet parameters of pregnant women with high normal blood pressure showed no significant difference compared with those with normal blood pressure,which provided a certain theoretical basis for the management of pregnant women with high normal blood pressure in the normal group.2.Prothrombin time,thrombin time and platelet volume distribution width are independent risk factors for hypertensive diseases during pregnancy.3.Prothrombin time,thrombin time and platelet volume distribution width all have certain predictive value for hypertensive diseases during pregnancy,and the combined value of the three is the highest. |
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