DOI: https://doi.org/10.36347/sjams.2026.v14i06.008

Pages: 923-929

Background: Pre-eclampsia and eclampsia are leading causes of maternal morbidity and mortality, especially in developing countries. Coagulation dysfunction is a serious complication in these disorders. Platelet count, routinely part of a complete blood count, has been proposed as a diagnostic marker. However, its diagnostic accuracy remains insufficiently evaluated in this population. This study aimed to determine the diagnostic accuracy of platelet count, using ROC analysis, for detecting coagulation disorder in pre-eclamptic and eclamptic patients. Methods: A cross-sectional analytical study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from June 2022 to May 2023. A total of 81 pregnant women were enrolled and divided into three equal groups of 27 each: pre-eclampsia, eclampsia and normal pregnancy (control). Platelet count and standard coagulation parameters (PT, APTT, serum fibrinogen, D-dimer) were measured. ROC analysis was performed to determine optimal diagnostic cut-off values, AUC, sensitivity and specificity. Results: Platelet count was significantly lower in pre-eclampsia (mean 217,777.8 ± 77,745.3 mm3) and eclampsia (mean 186,296.3± 91,728.6 mm3) compared to normal pregnant women (mean 252,296.3 ± 44,155.2 mm3; p<0.001). ROC analysis identified an optimal cut-off of 203,500 mm3 for eclampsia (AUC=0.778, sensitivity 70.4%, specificity 92.6%) and 218,000 mm3 for pre-eclampsia (AUC=0.719, sensitivity 66.7%, specificity 85.2%). At these cut-offs, sensitivity for detecting actual coagulation disorder fell to 45.45% and 46.51%, respectively, with an accuracy of 53.70% in both groups. Conclusion: Platelet count demonstrates moderate discriminatory capacity for distinguishing hypertensive pregnant women from normal pregnancies, but has poor sensitivity for detecting actual coagulation disorder. It cannot be recommended as a standalone diagnostic test for coagulation dysfunction in pre-eclampsia