Acil servise düşük tehdidi nedeniyle başvuran hastalarda sistemik inflamatuar belirteçlerin gebelik sonuçlarını öngörmede Etkisi

Abstract

Amaç: Erken gebelikte vajinal kanama acil servise en sık başvuru sebepleri arasındadır. Bu olgularda inflamasyonun önemli bir rol oynadığı ve ilerleyen dönemde oluşabilecek düşüklerin habercisi olabileceği düşünülmektedir. Çalışmanın amacı, abortus imminens (AI) tanısı ile acil servise başvurup hospitalize edilen hastalarda nötrofil-lenfosit oranı (NLO) ve platelet-lenfosit oranlarının (PLO) incelenmesi ve bu belirteçlerin gebelik sonuçlarını öngörmedeki etkinliklerinin değerlendirilmesidir.
Materyal ve Metot: Üniversite hastanesi acil servisine, gebeliğinin ilk 14 haftası içerisinde vajinal kanama şikâyeti ile başvurup AI tanısı alan toplam 121 hasta çalışmaya dahil edilmiştir. Bu hastalar; gebeliklerini abortus nedeniyle kaybedenler (n=73; %60,33) ve 24. hafta sonrasında gebeliği devam edenler (n=48; %39,66) olarak iki gruba ayrılmış olup, demografik veriler, inflamatuar belirteçler ve diğer hematolojik parametreler açısından karşılaştırılmıştır.      
Bulgular: Gruplar arasındaki demografik veriler benzer olarak saptanmıştır. Abortus grubunda NLO anlamlı şekilde yüksek bulunmuştur (3,92±2,01 ve 2,94±1,20; p<0,001). PLO açısından gruplar arasında anlamlı fark izlenmemiştir (p=0,071). Receiver operating characteristics (ROC) analiz ile değerlendirildiğinde NLO için %77 duyarlılık ve %63 özgüllük ile eşik değer 2,93 olarak belirlenmiştir.

Sonuç: AI patogenezinde inflamasyon önemli rol oynamaktadır. NLO kullanımı, acil servislerde gebelik sonuçlarını öngörmede faydalı olabilir. Kolay ulaşılabilir ve maliyet etkin olmaları sebebiyle inflamatuar belirteçlerin kullanıldığı daha büyük populasyon çalışmaları ile abortus olguları açısından önemli bilgiler edinilebilir.

Keywords

• Abortus imminens,NLO,PLO,acil servis

The effect of systemic inflammation markers on predicting pregnancy results in patients admitted to emergency department with threatened miscarriage

Abstract

Objectives: Vaginal bleeding in early pregnancy is one of the most common causes of emergency department (ED) admissions. It is thought that inflammation plays an important role in these cases and may be a predictor of miscarriages. The aim of this study was to evaluate the efficacy of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in predicting pregnancy outcomes in patients admitted to ED with abortus imminens (AI).          
Materials and Methods: A total of 121 patients admitted to the ED of a university hospital with the complaint of vaginal bleeding within the first 14 weeks of gestation with AI diagnosis were included in the study. These patients were divided into two groups; pregnant women who lost their pregnancies due to abortion (n = 73, 60,33%) and those who continued pregnancy after 24 weeks (n = 48, 39,66%). Demographic data, inflammatory markers and other hematological parameters were compared between the groups.          
Results: Demographic data were comparable between the groups. NLR was significantly higher in the abortion group (3,92 ± 2,01 vs. 2,94 ± 1,20, p<0,001), and there was no significant difference between the groups in terms of PLR (p=0,071). When the Receiver Operating Characteristics (ROC) analysis were evaluated for NLR, the threshold level was determined as 2,93 with 77% sensitivity and 63% specificity for predicting abortus risk.       
Conclusion: Inflammation plays an important role in the pathogenesis of AI. NLR can be a useful tool for predicting pregnancy outcomes in emergency services. Significant information can be obtained from larger population studies using this inflammatory markers because of their easy-to-reach and cost-effective nature.

Keywords

• Abortus imminens,NLR,PLR,emergency department

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