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

Year 2019, , 337 - 343, 28.06.2019

Eda Kan

https://doi.org/10.17098/amj.576455

Cited By: 1

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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