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J. Obstet. Gynaecol. Res. Vol. 41, No. 4: 650, April 2015

doi:10.1111/jog.12605

Letter to the Editor

Mean platelet volume may not be useful as a marker for prediction of preterm premature rupture of membranes Dear Editor, We read with interest the article by Ekin et al. published online about the mean platelet volume (MPV) levels and preterm premature rupture of membranes (PPROM).1 Because we have some concerns due to technical implementations, we would like to comment on this paper. Primarily, the authors suggested that MPV was an indicator of platelet function and activation. Beyan et al. showed no correlation between platelet indices, including platelet count, MPV, platelet distribution width and plateletcrit and platelet aggregation responses with adenosine diphosphate, collagen and epinephrine using light transmission turbidimetric platelet aggregometry the current gold standard test of platelet function.2 At present, MPV or other platelet indices are not used as platelet function tests according to current published work. When ethylenediaminetetraacetic acid (EDTA) is used as an anticoagulant, the MPV is increased up to 30% within 5 min after venipuncture and 10–15% over the next 2 h.3 Lancé et al. reported a study whose purpose was the standardization of the MPV measurement.4 They found that the timing was very important when measuring MPV, and the optimal measuring time with EDTA was established as 120 min after venipuncture. Because Ekin et al. performed their study in a retrospective manner and the time of measurement of samples was not known, the reliability of their data is questionable. Furthermore, a cut-off value should not be recommended for MPV because different technologies for measuring the MPV yield different results. Beckman Coulter LH 750 automated blood counter device was

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used only in the determination of platelet parameters in this study. The platelet parameters are highly specific to the individual technologies developed for each type of analyzer and studies comparing the results from these instruments have shown MPV differences of 40% or less. As a result, MPV may not be useful as a marker for prediction of PPROM during the first trimester of pregnancy.

Disclosure The authors have nothing to disclose. Cengiz Beyan1 and Esin Beyan2 Department of Hematology, Gulhane Military Medical Academy, and 2Kecioren Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey 1

References 1. Ekin A, Gezer C, Kulhan G, Avcı ME, Taner CE. Can platelet count and mean platelet volume during the first trimester of pregnancy predict preterm premature rupture of membranes? J Obstet Gynaecol Res Published online: 11 Aug 2014. doi:10.1111/jog.12484. 2. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis 2006; 22: 161–164. 3. Jackson SR, Carter JM. Platelet volume: Laboratory measurement and clinical application. Blood Rev 1993; 7: 104–113. 4. Lancé MD, van Oerle R, Henskens YM, Marcus MA. Do we need time adjusted mean platelet volume measurements? Lab Hematol 2010; 16: 28–31.

© 2014 The Authors Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology

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Mean platelet volume may not be useful as a marker for prediction of preterm premature rupture of membranes.

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