Journal of Life Science and Biomedicine  
J Life Sci Biomed, 9 (4): 117-121, 2019  
License: CC BY 4.0  
ISSN 2251-9939  
Hematological and selected biochemical indices  
in preeclamptic pregnant women attending  
Elnihoud teaching hospital  
Hafiz Ahmed Hobiel Ahmed1 and Mubarak Adam Suleiman Amin2  
1Department of Biochemistry, Faculty of Medicine and Health Sciences, West Kordufan University, West Kordufan State, Elnihoud City, Sudan  
2Department of Obstetric and Gynecology, Faculty of Medicine and Health Sciences, West Kordufan University, West Kordufan State, Elnihoud City, Sudan  
Corresponding author’s Email: hebiel78@yahoo.com  
ABSTRACT  
Research Article  
PII: S225199391900018-9  
Background. Preeclampsia (PE) is a form of hypertensive disorder of pregnancy, leading to maternal and  
perinatal morbidity and mortality worldwide. It is major obstetric problem in developing countries and  
affecting 210% of all pregnancies. Aim. This study aimed to evaluate hematological and some  
biochemical parameters in preeclamptic pregnant women attending Elnihoud Teaching Hospital,  
Sudan, and to compare the findings with the severity of the disease. Methods. A descriptive cross  
sectional study was carried out in Elnihoud Teaching Hospital with total of forty tow pregnant women  
as participants (1445 years old). They were selected from the Wards of the Hospital at admission  
before starting treatment. Hematological and selected biochemical parameters were measured and  
analyzed for every preeclamptic patient. Results. The study revealed no significant elevation in plasma  
total protein, total white blood cells (TWBCs), lymphocytes and mean corpuscular volume (MCV) among  
severe preeclamptic patients versus mild cases. Decrease with no significant value in hemoglobin level,  
platelets count (PLT), red blood cells (RBCs) and mean corpuscular hemoglobin (MCH) was observed in  
Rec.  
Rev.  
Pub.  
06 June 2019  
15 July 2019  
25 July 2019  
Keywords  
Preeclampsia,  
Hypertension,  
severe preeclamptic cases compared to mild preeclamptic cases. Conclusion. It is concluded that Proteinuria,  
measurement of hematological and some biochemical parameters might reflect to some extent the effect  
of preeclampsia on pregnant women. Recommendation. Further studies with more parameters can  
provide guidance for the evaluation intervention and management of pregnant women who suffering  
from PE.  
Papillodema.  
INTRODUCTION  
Preeclampsia is one of the most serious health problems affecting pregnant women and contributes to both  
maternal and infant morbidity and mortality worldwide [1]. The disorder is defined by the onset of hypertension  
(blood pressure 140/90 mm Hg) and proteinuria (0.3 g of protein in the urine within a 24-hour period) during  
the second half of pregnancy (20 weeks) in a woman with previously normal blood pressure [2]. Although  
multiple mechanisms and factors have long been recognized, including increased oxidative stress; abnormal  
placentation; cardiovascular maladaptation to pregnancy; malfunction in genetic, immunological, nutritional,  
hormonal, angiogenic mechanisms; and inflammation the understanding of the exact pathophysiology of  
preeclampsia has been elusive [3, 4].  
Systemic inflammation can be measured by using a variety of biochemical and hematological markers  
might provide prognostic and diagnostic clues to diseases related to chronic low-grade inflammation [5-7]. In  
Sudan there is high prevalence of maternal mortality with PE, and accounting 4.2% of all obstetric  
complications and 18.1% of maternal deaths [8].  
The aim of the current study was to evaluate plasma total protein, hemoglobin, total white blood cells  
(TWBCs), red blood cells (RBCs), platelets count (PLT), lymphocytes, packed cell volume (PCV), mean corpuscular  
volume (MCV) and mean corpuscular hemoglobin, or "mean cell hemoglobin" (MCH) as complete blood count  
for preeclamptic patients attending Elnihoud Teaching Hospital and to compare the findings with the severity  
of the disease.  
MATERIAL AND METHODS  
This study was descriptive cross sectional study; carried out in Elnihoud Teaching Hospital, Elnihoud Locality,  
West Kordufan State, Sudan from January 2018 to December 2018. A total of forty tow pregnant women were  
included in this study. They were selected from the Wards of the Hospital at admission before starting  
treatment.  
Citation: Hobiel Ahmed HA and Suleiman Amin MA. 2019. Hematological and selected biochemical indices in preeclamptic pregnant women attending Elnihoud  
teaching hospital. J Life Sci Biomed, 2019; 9(4): 117-121; www.jlsb.science-line.com  
117  
Inclusion criteria  
Preeclamptic women with ages 14 – 45 years old, blood pressure ≥ 140/90, and also with proteinuria  
≥300mg/24hrs urine collection were included. Preeclamptic patients with blood pressure ≥ 160/110 or/and  
proteinuria ≥ 1g/ 24 hours urine collection or/and presence of papillodema were taken as severe preeclamptic  
cases, while preeclamptic patients with blood pressure 159/109 140/90, proteinuria 0.3 to 1g/ 24 hours urine  
collection and absence of papillodema taken as mild preeclampsia.  
Exclusion criteria  
Pregnant women with pre-gestational diabetes mellitus, primary or secondary lipid disorders, severe  
anemia, those suffer from any other hematological or endocrine disorders were excluded. Questionnaires were  
filled and blood samples were obtained for measurement of laboratory parameters by using chemical and  
hematological analyzers. Data were analyzed by SPSS program version 20.  
Ethical approval  
The review board and ethics committee of University of West Kordufan for Medical Education and  
Research approved the study protocol and informed consents were taken from all the participants.  
RESULTS  
Figure 1 show the ages of participants which were 14 20 (28.5%), 21 25 (21.5%), 26 30 (30.9%) and > 30  
(19.1%). Figure 2 shows the parity of the study group, primiparous (45.2%), multiparous (34.7%) and grand  
multiparous (19.2%). From the entire participants, (76%) have severe preeclampsia and (24%) have mild  
preeclampsia.  
Characteristics and description of the study group  
Table 1 shows the characteristics and description of the study group. The occupations of the participants  
were teacher (2.4%), employee (2.4%), farmer (7.1%) and housewife (88.1%). The study group ages at time of  
marriage per year were 14-20 (73.8%), 21-25 (14.3%), 26-30 (7.1%) and > 30 (4.8%) years old. Regarding gestational  
ages at onset of preeclampsia per week they were 20 - 24(9.5%), 24+1 28(7.1%), 28+1 32(19%), 32+1 36(40.5%)  
and > 36(23.9%). The participants having blood pressure ≥ 160/110 represent (42.9%) and those having blood  
pressure 159/109 140/90 were (57.1%)  
Laboratory findings of study group  
Table 2 shows the laboratory findings of the participants. Proteinuria (dipstick) for the study group were +  
(19%), ++ (42.9%) and +++ (38.1%), and there was significant elevation in the cases of severe preeclampsia with ++  
and +++ (P=0.052). (52.4%) of the participants have proteinuria from 0.3 1 and (47.6%) have proteinuria > 1 with  
significant elevation in sever preeclampsia compared to mild preeclampsia (P=0.002). Plasma total protein for  
the study group was (33.3%) normal (66.7%) high and no participant having low plasma total protein and there  
was no significant difference between sever and mild cases. Hemoglobin level for participants was (81%) low,  
(19%) normal and no patient have high hemoglobin level and there was no significant difference between sever  
and mild cases. For TWBCs, (83.3%) of participants their TWBCs were normal, (16.7%) have leucocytosis and no  
one have low TWBCs count, with no significant difference between sever and mild patients. Regarding the RBCs  
for study group, (11.9%) have low count, (85.7%) their RBCs were in normal range, while (2.4%) have high RBCs  
count and there was no significant difference between sever an mild cases. Concerning PLT, (38.1%) low PLT,  
(57.1%) normal PLT count and (4.8%) high PLT count with no significant difference between sever and mild  
cases. For lymphocytes, (31%) of the participants have normal lymphocytes (69%) have high lymphocytes and no  
one have low lymphocytes count with no significant difference between sever and mild preeclamptic patients.  
(2.4%) of entire participants have low MCV, no normal MCV, while (97.6%) have high MCV and there was no  
significant difference between sever and mild cases. For MCH, (92.9%) of the participants have low MCH, (2.4%)  
have normal MCH and (4.8%) have high MCH, with no significant difference between sever an mild cases in all.  
38.1%  
Mild Sever  
Age/year  
Mild Sever  
Parity  
23.8%  
21.4%  
16.7%  
23.8%  
14.3%  
14.3%  
11.9%  
7.1%  
7.1%  
7.1%  
4.8%  
4.8%  
4.8%  
Primiparous  
Multiparous  
Grand multiparous  
Ages (> 30)  
Ages (26-30)  
Ages (21-25)  
Ages (14-20)  
Figure 1. Ages of the study group  
Figure 2. Parity of the study group  
Citation: Hobiel Ahmed HA and Suleiman Amin MA. 2019. Hematological and selected biochemical indices in preeclamptic pregnant women attending Elnihoud  
teaching hospital. J Life Sci Biomed, 2019; 9(4): 117-121; www.jlsb.science-line.com  
118  
Table 1. Characteristics and description of the study group  
Preeclampsia status  
Sever  
Character  
p-value  
Mild  
0
Total  
1(2.4%)  
Teacher  
1(3.1%)  
Employee  
Farmer  
0
0
1(3.1%)  
3(9.4%)  
1(2.4%)  
3(7.1%)  
Occupation  
0.621  
Housewife  
10(100%)  
10(100%)  
7(70%)  
2(20%)  
0
1(10%)  
10(100%)  
2(20%)  
0
27(84.4%)  
32(100%)  
24(75%)  
4(12.5%)  
3(9.4%)  
1(3.1%)  
32(100%)  
37 (88.1%)  
42 (100%)  
31(73.8%)  
6(14.3%)  
3(7.1%)  
2(4.8%)  
42 (100%)  
Total  
14 20  
21 25  
26 30  
> 30  
Age at time of marriage/year  
0.693  
Total  
20 24  
24+1 28  
2(6.3%)  
3(9.3%)  
4(9.5%)  
3(7.1%)  
Gestational age at onset of preeclampsia / week  
28+1 32  
32+1 36  
> 36  
2(20%)  
5(50%)  
1(10%)  
10(100%)  
6(18.8%)  
11(34.4%)  
10(31.2%)  
32(100%)  
8(19%)  
0.372  
0.002  
17(40.5%)  
10(23.9%)  
42 (100%)  
Total  
≥ 160/110  
159/109 140/90  
0
18(56.3%)  
14(43.7%)  
32(100%)  
18(42.9%)  
24(57.1%)  
42 (100%)  
Blood pressure  
Total  
10(100%)  
10(100%)  
Table 2. Laboratory findings of study group  
Preeclampsia status  
Character  
p-value  
0.052  
Mild  
Sever  
Total  
Proteinuria (dipstick)  
+
++  
+++  
Total  
4(40%)  
5(50.8%)  
1(10%)  
4(12.5%)  
13(40.6%)  
15(46.9%)  
32(100%)  
8(19%)  
18(42.9%)  
16(38.1%)  
42 (100%)  
10(100%)  
Proteinuria  
0.3 1  
> 1  
Total  
10(100%)  
0
10(100%)  
14(43.7%)  
18(56.3%)  
32(100%)  
24(57.1%)  
18(42.9%)  
42 (100%)  
0.002  
Plasma total protein  
Low  
0
0
0
Normal  
High  
Total  
2(20%)  
8(80%)  
10(100%)  
12(37.5%)  
20(62.5%)  
32(100%)  
14(33.3%)  
28(66.7%)  
42 (100%)  
0.451  
1.00  
Hemoglobin  
Low  
Normal  
High  
8(80%)  
2(20%)  
0
26(81.3%)  
6(18.7%)  
0
34(81%)  
8(19%)  
0
Total  
10(100%)  
32(100%)  
42 (100%)  
Total white blood cells  
Low  
0
0
0
Normal  
High  
Total  
10(100%)  
0
10(100%)  
25(78.1%)  
7(21.9%)  
32(100%)  
35(83.3%)  
7(16.7%)  
42 (100%)  
0.168  
0.335  
Red blood cells  
Low  
Normal  
High  
0
5(15.6%)  
26(81.3%)  
1(3.1%)  
5(11.9%)  
36(85.7%)  
1(2.4%)  
10(100%)  
0
Total  
10(100%)  
32(100%)  
42 (100%)  
Platelets count  
Low  
Normal  
High  
3(30%)  
7(70%)  
0
13(40.6%)  
17(53.1%)  
2(6.3%)  
16(38.1%)  
24(57.1%)  
2(4.8%)  
0.541  
1.000  
0.238  
0.192  
Total  
Lymphocytes  
10(100%)  
32(100%)  
42 (100%)  
Low  
Normal  
High  
Total  
0
0
0
3(30%)  
7(70%)  
10(100%)  
10(31.2%)  
22(68.8%)  
32(100%)  
13(31%)  
29(69%)  
42 (100%)  
Mean corpuscular volume  
Low  
Normal  
High  
Total  
1(10%)  
0
9(90%)  
10(100%)  
0
0
1(2.4%)  
0
41(97.6%)  
42 (100%)  
32(100%)  
32(100%)  
Mean corpuscular hemoglobin  
Low  
Normal  
High  
Total  
9(90%)  
1(10%)  
0
30(93.8%)  
0
2(6.2%)  
32(100%)  
39(92.9%)  
1(2.3%)  
2(4.8%)  
10(100%)  
42 (100%)  
Citation: Hobiel Ahmed HA and Suleiman Amin MA. 2019. Hematological and selected biochemical indices in preeclamptic pregnant women attending Elnihoud  
teaching hospital. J Life Sci Biomed, 2019; 9(4): 117-121; www.jlsb.science-line.com  
119  
DISCUSSION  
Although PE only affects approximately 2%8% of pregnancies worldwide it is associated with severe  
complications such as eclampsia, hemorrhagic stroke, hemolysis, elevated liver enzymes and low platelets  
(HELLP syndrome), renal failure and pulmonary edema in addition to other variable mode of clinical  
presentation and hematological and biochemical changes . Importantly, there is no “cure” for the disease except  
for early delivery of the baby and placenta [9].  
Hypertension, proteinuria, excessive weight gain and edema are classic clinical manifestations of the  
preeclampsia [10]. Other features include thrombocytopenia, hyperuricemia, abnormal liver function tests and  
hemoconcentration [11].  
The current study revealed that most of the participants were, marriage at age 14 20 years old (73.8%),  
with sever preeclampsia (76%) their blood pressure 159/109 140/90 (57.1%). The present study shows  
significant increase in proteinuria (dipstick) and proteinuria among the sever preeclamptic participants  
compared to mild group. The elevation of proteinuria showed by the current study might be attributed to  
impairment of glomerular filtration and loss of intermediate weight proteins such as albumin and transferrin as  
consequence of preeclampsia.  
The study revealed an elevation in the plasma total protein, TWBCs, lymphocytes and MCV among severe  
preeclamptic patients versus mild cases but with no significant values. These findings were in agreement with  
Vilchez et al. and Elgari et al. [12, 13] whom stated similar results. The results of the present study disagree with  
similar studies results carried out by Hale et al. and Ali et al. [14, 15] whom reported that there was decrease  
with no significant value in the levels of those parameters in preeclamptic women. The elevation of those  
parameters which revealed by the present study might be due to endothelial damage that associated with  
preeclampsia.  
For hemoglobin level, PLT, RBCS and MCH the study shows decrease with no significant values in severe  
preeclamptic cases compared to mild preeclamptic cases. These findings were in accordance with similar  
studies results carried out by Hale et al. and Ali et al. [14, 15] whom reported that there was no significant  
decrease in the levels of those parameters in preeclamptic women. In contrast, the PLT result of the current  
study disagrees into some extent with Imteyaz et al. and Yaprak et al. [16-18] whom stated that there was  
significant decrease in PLT level among severe preeclamptic women. Preeclampsia is associated with  
hematological system impairment and that is might be the cause of the decrease of those parameters which  
shown by this study.  
CONCLUSION AND RECOMMENDATIONS  
Preeclampsia as multisystemic disorder can exhibit its harmful effect on all body organs and systems. Because  
measurement of some biochemical and hematological parameters is fast and easily applicable, they may be used  
to evaluate to some extent the effect of preeclampsia on pregnant women.  
Further studies with more parameters can provide guidance for the evaluation intervention and  
management of pregnant women who suffering from PE.  
DECLARATIONS  
Acknowledgements  
Many thanks to our colleagues in the Faculty of Medicine and Health Sciences and for the staff workers in  
Elnihoud Teaching Hospital.  
Authors’ Contributions  
All authors contributed equally to this work.  
Competing interests  
The authors declare that they have no competing interests.  
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teaching hospital. J Life Sci Biomed, 2019; 9(4): 117-121; www.jlsb.science-line.com  
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Citation: Hobiel Ahmed HA and Suleiman Amin MA. 2019. Hematological and selected biochemical indices in preeclamptic pregnant women attending Elnihoud  
teaching hospital. J Life Sci Biomed, 2019; 9(4): 117-121; www.jlsb.science-line.com  
121