Determination of Platelet Count and platelet Indices in Women after Normal Delivery in Shendi Town, Sudan

Background : Delivery is the process of birth. As the uterus contracts, the lower part stretches and thins, the cervix expands, the birth canal is formed, and the baby sinks through the pelvis, Platelet counts of less than 150,000 per cubic millimeter during uncomplicated pregnancies are described as gestational thrombocytopenia if no alternative cause is identified. Platelet counts may be even lower in women with pregnancy-related complications. Objective: The purpose of this study was to measure the platelet count and platelet index in women after normal delivery. Methods: This descriptive study was conducted in the city of Shendi during the period from March (2021) to January (2022) and measured the platelet count and platelet index in women after normal delivery. P.value of the test at the 95-confidence level was 0.000, less than 0.05, indicating significant variation between the case and control groups in platelet counts. Hundreds of venous blood samples were collected for use in this study, 50 of which were collected from the test group and 50 from the control group. Platelet counts and platelet indices (including platelet critical value (PCT), platelet distribution width (PDW), and mean platelet volume (MPV) were determined for all samples and performed in an automated manner using a hematology analyzer. Results: The study showed that the mean platelet count in the delivery group was 147.84 compared to 263.14 in the control group. The P. value was significant (P. value 0.000). The most affected age for platelet count in the study group was 30 years and older, with a platelet count percentage of 84%. The most effective number of workers for platelet counts in postpartum women was 2 or more workers. The platelet count percentage was 84%. The study showed that the mean platelet volume (MPV) for the delivery group was 8.696 compared to 8.616 for the control group. The value of the test was not significant (0.620). The mean platelet distribution width (PDW) was 15.750 for the treatment group and 15.828 for the control group. The P. value was not significant (0.418).


Introduction
Platelets are produced in the bone marrow by cytoplasmic fragmentation of megakaryocytes, one of the largest cells in the body. Megakaryoblasts, precursors of megakaryocytes, are formed through a differentiation process from hematopoietic stem cells. Mature megakaryocytes are extremely nuclear and have a low nucleocytoplasmic ratio. Each megakaryocyte produces approximately 1000-5000 platelets. The primary function of platelets is the formation of mechanical plugs during the normal hemostatic response to vascular injury [1]. These cells are composed of cytoplasmic granules and membranes containing procoagulant molecules. It highlights glycoproteins from the membrane that aim to enable platelet-platelet and platelet-endothelial interactions [2]. Labor is the process of childbirth. As the uterus contracts, the lower part stretches and thins, the cervix expands, the birth canal is formed, and the baby descends through the pelvis [3]. Platelet counts of less than 150,000 per cubic millimeter during uncomplicated pregnancies are described as gestational thrombocytopenia if no alternative cause is identified. Platelet counts may be even lower in women with pregnancy-related complications. However, the occurrence and severity of thrombocytopenia throughout pregnancy are not defined [4]. Beginning in 1993, three large studies documented that 5 to 10% of women who had uncomplicated pregnancies had a platelet count of less than 150,000 per cubic millimeter at the time of delivery [5,7], which was described as gestational thrombocytopenia [8]. The normal distribution of platelet counts at the time of delivery and the absence of health problems in the mother and infant suggested that gestational thrombocytopenia was the result of lower platelet counts that occur in all women during pregnancy [6,7,9,10]. The current thinking is that platelet counts in all women begin to decrease in the mid-second to third trimester and continue to decrease until the time of delivery [8]. Mild thrombocytopenia in pregnant women at the time of delivery, described as gestational thrombocytopenia, has been well documented in three large studies during that past 24 years [4]. The reduced, but symmetrical, distribution of platelet counts at delivery suggests that a shift from normal values to lower platelet counts occurs in all women. These observations have led to the common belief that a physiologic change associated with pregnancy causes platelet counts to gradually decrease [4].

Materials And Methods
Study design This is a cross-sectional descriptive study conducted in the city of Shendi to measure platelets and platelet parameters in a woman after normal delivery during the period from March (2021) to January (2022).

Study area
This research was conducted in Shendi City.

Study population
Hundreds of venous blood samples were collected into her EDTA container, 50 from normal women and 50 from women after vaginal delivery.

Inclusion Criteria
The study included women after normal delivery in Shendi.

Exclusion Criteria
Women after normal delivery excluded Shendi from this study. Data collection tools Data were collected using a self-administered, precoded questionnaire designed specifically to obtain research-useful information.

Ethical considerations
The procedure for taking venous blood is described for women who have given birth normally. All participants were briefed on the purpose and procedures of the study during the interview period. Valid written consent was obtained from all participants.

Data Analysis
Data are calculated and analyzed using the Social Science Software Program version 21.0 statistical package. Mean values are obtained and frequencies and percentages of other variables are calculated and displayed in numerical and tabular form. P. value is used to assess the significance of the results.

Results
The study showed that the mean platelet count in the delivery group was 147.84 compared to 263.14 in the control group. The p-value of the test was significant (pvalue 0.000) (Table3). The most affected age in terms of platelet count in the study group was 30 years and older, with a platelet count percentage of 84% (Table1). The most effective number of laborers for platelet counts in postpartum women was 2 or more laborers. The platelet count percentage was 84% (Table2). statistical analysis of gathered data reveals that mean of platelet count in case of delivery group was147.84, while it was 263.14 in control group, The P. value of the test was significant (P. value 0.000) (Table3). Mean of platelet volume (MPV) in case of delivery group 8.696, while in control group it was 8.616, The P. value of the test was insignificant (0.620) (Table4). Mean of platelet distribution width (PDW) in case of delivery group 15.750, While in control group it was 15.828, The P. value was insignificant (0.418) (Table5). Mean of platelet crit (PCT) in case of delivery group was 0.150, while in control group was 0.228 (Table6).

Discussion
Delivery is the process of birth. As the uterus contracts, the lower part stretches and thins, the cervix expands, the birth canal forms, and the baby sinks through the pelvis. The platelet count and platelet index (PCT) were shown to be significantly decreased in the test group (P.

Conclusion
Delivery causes a slight decrease in platelet count, but within normal limits. There was no significant change in mean platelet volume (MPV) after normal delivery. There was no significant change in platelet distribution width (PDW) after normal delivery. Significant reduction in platelets (PCT) after normal delivery.