Poor predictive value of platelet count, mean platelet volume and serum urate in hypertension in pregnancy

Objective: To determine the usefulness of platelet count, mean platelet volume and serum uric acid levels in the prediction of preeclampsia in women with mild hypertension in pregnancy, and to see if it is appropriate to base the management of such patients on these tests. Subjects: Three hundred and thirty-six women attending the antenatal day unit with a diagnosis of non-proteinuric hypertension in pregnancy (diastolic blood pressure greater than or equal to 90 mmHg on two separate recordings) from whom at least one blood sample was taken. Main outcomes measured: The development of proteinuria (1 + or greater on urine Albustix); the need for oral antihypertensive medication, the need for the 'pre-eclampsia regime' intra- or post-partum; the need for induction of labour because of hypertension. Results: No test, at any cut-off level, was found to be of any use in predicting the outcomes studied. Nor was a weekly change in any of the tests found to be of any use. Conclusion: Basing the management of patients with mild non-proteinuric hypertension on the results of platelet count, mean platelet volume or urate level is unwise as none of these tests was able to predict outcome in such patients.