Role of Platelet Distribution Width and Mean Platelet Volume in Diagnosis of Ectopic Pregnancy

Abstract

Ectopic pregnancy [EP] is a common complication of pregnancy where the implantation occurs outside the uterus. For
diagnosis of EP it mainly depends on transvaginal ultrasound and some markers in the serum, especially beta-human
chorionic gonadotropin [β-hCG]. However, these facilities are not always available in some health centers. Thus, it is
indispensable to find easier and cheaper alternatives. current study aimed to assess the diagnostic value of platelet
distributional width [PDW] and the mean of platelet volume [MPV] for detection of EP and if there is discrimination
between ruptured and non-ruptured EP. This study is a prospective cross-section including a total of 40 women with EP
[23 with ruptured EP and 17 with non-ruptured EP] at child-bearing age. Other 40 women having a history of 6-8 weeks of
normal intrauterine pregnancy [confirmed by sonograph examination] were included as controls. Demographic
informational data were collected by direct interview. The samples of blood were collected in EDTA tube. Each of
hemoglobin, RBC count, platelet count, PDW and MPV were calculated. PDW was higher in patients than controls
[15.83±2.09 fL versus 14.62±2.61 fL] where difference was significant [p value = 0.025], while MPV was significantly
lower in EP patients [7.13±1.05 fL] than controls [7.83±1.82 fL] [p value = 0.037]. MPV had better diagnostic value than
PDW sensitivity and specificity of the MPV with cut off value 7.45 fL were 0.80, 0.625 respectively, indicating a moderate
descriptive value, while in PDW the sensitivity and specificity with cut off value of 15.25 fL were 0.575 and 0.675
respectively, indicating a low descriptive value. Regarding rupture and non-rupture EP there was no significant difference
neither for PDW nor MPV. EP induces platelets activation which is manifested by low MPV and high PDW. The MPV
value can be used as a diagnostic test for early detection of EP when US and/or βhCG are not available. Both MPV and
PDW have no discriminative value between ruptured and non-ruptured EP.