Abstract Background: Pregnancy is naturally a hypercoagulable state due to physiological changes in the coagulation and fibrinolytic systems. This tendency is thought to be worsened in preeclampsia (PE). However, despite the pro thrombotic environment, PE is also linked to a high risk of bleeding complications because of underlying coagulation abnormalities. Objectives: This study aimed to compare coagulation parameters between women with PE and normotensive pregnant women, and to assess related maternal and fetal outcomes. Materials and Methods: A total of 200 pregnant women were enrolled in the study, including 96 patients diagnosed with PE and 104 healthy, normotensive controls. Blood samples were collected to assess coagulation profiles, and maternal–fetal outcomes were analyzed in both groups. Results: Women with PE exhibited significantly higher levels of prothrombin time, activated partial thromboplastin time, and D-dimer ( P < 0.0001). Conversely, mean platelet counts and fibrinogen levels were notably lower in the PE group, with a P value of 0.0074 and <0.0001, respectively. Additionally, bedside clot formation testing using the modified Lee–White method showed a significant correlation with elevated D-dimer levels ( P < 0.0001) in PE patients. These findings indicate a development of a hyper-coagluable state in pregnancies complicated by PE, especially as they near term. A markedly higher occurrence of postpartum hemorrhage (PPH) was observed in the PE group ( P = 0.0004). However, there were no statistically significant differences in the mode of delivery or neonatal outcomes between the two groups. Conclusion: Coagulation abnormalities and thrombocytopenia were more evident in women with PE. Our study highlights the progression toward a hyper-coagluable state in PE, contributing to a greater risk of PPH as gestation advances.
Ali et al. (Tue,) studied this question.