الفهرس 
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Abstract
Preeclampsia (PE) is a serious condition diagnosed by the increase in blood pressure more than or equal to 140/90 mm Hg and proteinuria after the 20th week of pregnancy. It represents 2–8% of all pregnancies around the world (ACOG, 2020).
PE can cause serious complications on the mother and the fetus, so many researchers are trying to find a screening test that can predict the risk of preeclampsia and its severity. Changes in platelet count (PC), neutrophil-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) have been investigated in PE. These indices are available, inexpensive, and measured during ordinary blood investigation (Mannaerts et al., 2019).
In this study we aimed to compare the systemic inflammatory markers NLR and PLR in women with pre-eclampsia and gestational-age-matched healthy controls. We also aimed to determine any association between various platelet indices such as MPV, platelet distribution width (PDW), and plateletcrit (Pct) and pre-eclampsia.
This study was conducted on 168 pregnant women in Menoufia University hospital divided into 2 subgroups:
I) PE group: included 84 pregnant women with PE admitted to Menoufia University hospital.
II) Control group: including 84 healthy of matched gestational age with PE group.
Inclusion criteria:
Pregnant women aged 18–40 years ≥ 34 weeks of pregnancy who presented with pre-eclampsia.
Blood pressure elevation ≥140/90 mm Hg on two occasions 4 hours apart
Summary
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Proteinuria
Any of the severe features of pre-eclampsia; thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, cerebral or visual disturbances.
Control group, healthy pregnant women aged 18–40 years ≥ 34 weeks of pregnancy with normal blood pressure, without proteinuria or any pregnancy complications.
Exclusion criteria:
Women with a history of ruptured membranes, anemia, infections, fever, HELLP syndrome, multiple pregnancy, eclampsia, or coexisting morbidities (such as diabetes, hypothyroidism, chronic hypertension, collagen vascular disease, renal disease, or ischemic heart disease).
Methods:
All patients incorporated in this study were subjected to the following:
I- Full history taking including present, past, menstrual, obstetric, medical, surgical, and family history.
II- obstetric examination at admission:
III- Severity of pre-eclampsia including blurred vision, upper abdominal pain, nausea, vomiting, and pedal edema.
IV- Measure Blood pressure and urine albumin is estimating using a dipstick test.
V- Venous blood samples are drawn before delivery. Complete blood count is analyzed. The analysis of CBC values including hemoglobin level, platelet count, and WBC differential counts.
VI- NLR and PLR are calculated after obtaining the absolute values.
Summary
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The results of our study demonstrated that:
Protein in urine in 24h was significantly elevated in pregnant women with preeclampsia compared to normal pregnant women. Protein in urine in 24h was significantly elevated in pregnant women with severe pre-eclampsia compared to those with mild pre-eclampsia. There was no significant difference between the two studied groups in terms of maternal age, systolic and diastolic blood pressure. There was a significant increase in INR and neutrophils in pregnant women with pre-eclampsia. There was a significant increase in TLC and neutrophiles in women with severe pre-eclampsia compared to the mild pre-eclampsia group. There was a highly significant increase in NLR and PLR in pregnant women with pre-eclampsia compared to normal pregnant women. There was a significant increase in NLR and PLR in women with severe pre-eclampsia compared to the mild pre-eclampsia group. NLR and PLR showed that they were the most powerful predictors of pre-eclampsia. There was a positive correlation between NLR and systolic, diastolic blood pressure, neutrophiles, and gestational age at delivery. There was a negative correlation between NLR and platelets. Regarding PLR, there was a positive correlation with platelets, and GA at delivery. There was a negative correlation between PLR and systolic, diastolic blood pressure and neutrophiles was noted.