TITLE:
Frequency of Coagulation Abnormalities in Women with Preeclampsia with Severe Features and Their Association with Maternal Disease Severity and Fetal Outcomes
AUTHORS:
Arifa Sharmin, Quazi Rubyata Sania, Hafiza Farzana, Urmila Majumder, Jesika Rizvi Tamanna, Raunak Jahan, Nasrin Akter, Alif Laila
KEYWORDS:
Preeclampsia, Severe Features, Coagulation Abnormalities, Thrombocytopenia, D-Dimer, Fetal Growth Restriction, Birthweight, Bangladesh
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.10,
October
21,
2026
ABSTRACT: Background: Preeclampsia with severe features remains a major cause of maternal and perinatal morbidity in South Asia, yet haemostatic derangement and its relevance to fetal compromise are poorly characterised in Bangladesh. Objective: To determine the frequency of coagulation abnormalities in women with preeclampsia with severe features and their association with maternal disease severity and fetal outcomes. Methods: This analytical cross-sectional study enrolled 216 consecutive women with preeclampsia with severe features at Dhaka Medical College Hospital from March to September 2026. Any coagulation abnormality was defined as platelet count 16.1 s, activated partial thromboplastin time (aPTT) >40 s, or D-dimer >1.7 mg/L (fibrinogen-equivalent units). Scans were performed at or after admission blood sampling. Multivariable regression estimated adjusted associations. Results: Overall, 140 women (64.8%; 95% CI 58.0 - 71.2) had at least one coagulation abnormality; thrombocytopenia (48.6%) and elevated D-dimer (39.4%) predominated, followed by prolonged aPTT (19.4%) and PT (16.7%). Affected women more often had severe-range blood pressure (93.6% vs 60.5%), serum creatinine ≥1.1 mg/dL (55.7% vs 18.4%), and alanine aminotransferase ≥70 U/L (25.7% vs 2.6%) (all P β −0.151 kg; 95% CI −0.270 to −0.032; P = 0.013). Preterm delivery did not differ significantly between groups. Conclusion: Nearly two-thirds of women with preeclampsia with severe features have coagulation abnormalities, which indicate more advanced end-organ involvement and placental compromise. A low-cost admission coagulation panel may help prioritise early fetal ultrasound and Doppler assessment in resource-limited settings; its predictive value requires prospective study.