Coagulation Profile in Patients with Pre-Eclampsia at the Mother and Child Hospital, Akure, Ondo State, South West Nigeria

This study evaluates the coagulation profile of pre-eclamptic women at the Mother and Child Hospital, Akure, Ondo State, South West Nigeria. Pre-eclampsia is characterised by endothelial activation, platelet consumption, and coagulation factor disturbances that can progress to life-threatening complications including eclampsia and HELLP syndrome. A case-control study enrolled 80 women with confirmed pre-eclampsia based on WHO diagnostic criteria and 80 normotensive pregnant women at comparable gestational ages as controls. Prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, platelet count, and serum lactate dehydrogenase were assessed. Urine protein and blood pressure readings were documented. Findings showed significantly prolonged PT and elevated D-dimer in pre-eclamptic patients compared to normotensive controls. Fibrinogen levels were paradoxically elevated in mild pre-eclampsia, reflecting acute phase reactant increase, but declined significantly in severe pre-eclampsia cases approaching HELLP syndrome criteria. Thrombocytopenia (platelet count below 100 times ten to the ninth per litre) was observed in 23.8 percent of severe cases. A composite coagulation risk score developed from the study data identified patients at highest risk of HELLP progression with 79 percent sensitivity. Serial coagulation monitoring is recommended for all pre-eclamptic patients at the Akure facility, with escalation of care for patients showing worsening coagulation indices. Keywords: pre-eclampsia, coagulation profile, HELLP syndrome, fibrinogen, Ondo State.