Haematological and Coagulation Parameters as Predictors of Preeclampsia Severity in Pregnant Women in Osun State, South West Nigeria

Preeclampsia remains a leading cause of maternal mortality in Nigeria, and haematological and coagulation derangements are central to its pathophysiology, potentially serving as early warning biomarkers for severity stratification. This study assessed haematological and coagulation parameters as predictors of preeclampsia severity in pregnant women at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, South West Nigeria. A case-control study enrolled 60 women with mild preeclampsia, 60 with severe preeclampsia, and 60 normotensive pregnant controls. Full blood count, peripheral film, platelet count and function, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, and lactate dehydrogenase were assessed. Haematocrit was elevated and platelet counts significantly reduced in severe preeclampsia compared to mild cases and controls. Thrombocytopaenia below 100 x 10 to the 9 per litre was present in 36.7% of severe cases. D-dimer was markedly elevated in severe preeclampsia, with AUC of 0.87 for distinguishing severe from mild disease. Prolonged PT and elevated fibrinogen indicated evolving consumptive coagulopathy in severe cases. LDH above 600 IU/L combined with thrombocytopaenia had 83.3% sensitivity for severe preeclampsia. A composite score incorporating platelet count, D-dimer, and LDH had the best predictive performance with AUC of 0.92. The study recommends implementation of composite laboratory panels for preeclampsia severity stratification at all maternity centres across South West Nigeria and integration of these parameters into obstetric emergency protocols. Keywords: preeclampsia, thrombocytopaenia, D-dimer, coagulopathy, severity prediction