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The immature platelet fraction in hypertensive disease during pregnancy



The aim of our study was to elucidate the role of IPF in preeclampsia, because the immature platelet fraction (IPF) is available in most emergency departments. A number of parameters have been introduced to diagnose preeclampsia/HELLP syndrome. The defined cutoffs of angiogenic and antiangiogenic parameters, soluble fms-like tyrosine kinase 1 and placental growth factor, have been approved for clinical routine. However, these parameters need complex analysis and are expensive.


The data of 69 pregnant women between 20 and 42 weeks of gestation were analyzed in this retrospective monocentric study. 28 of them had preeclampsia, HELLP syndrome or partial HELLP syndrome fitting the Tennessee criteria (study group 1). Furthermore, 41 normotensive pregnant women were included as controls (study group 2). In both groups the IPF was analyzed.


In this study, we demonstrated that the values of IPF were significantly higher in patients with hypertensive diseases than in normotensives, but could not distinguish between preeclampsia and HELLP syndrome. The absolute number of immature platelets of women with preeclampsia was significantly higher and those of HELLP syndrome were significantly lower than values of healthy women. The absolute number of immature platelets as well as mature thrombocytes helps to distinguish between HELLP syndrome and preeclampsia.


IPF levels are higher in women with hypertensive pregnancy than in normotensive controls. They could be used to diagnose hypertensive diseases in pregnancy. To distinguish between preeclampsia and HELLP syndrome, thrombocytes or the absolute number of immature platelets is needed.

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Authors and Affiliations



UB: protocol/project development, data collection, data analysis, manuscript writing/editing. TK: data collection or management. HS: manuscript writing/editing. AJ: protocol/project development, data analysis, manuscript writing/editing/correcting and adding the revisions.

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Correspondence to Alexander Jank.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bernstein, U., Kaiser, T., Stepan, H. et al. The immature platelet fraction in hypertensive disease during pregnancy. Arch Gynecol Obstet 299, 1537–1543 (2019).

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  • Preeclampsia
  • HELLP syndrome
  • Immature platelet fraction (IPF)