Missed abortus ile platelet indekslerinin ilişkisi

Abstract

Amaç: Klinik olarak tanı almış gebeliklerin %15’i missed abortus ile sonuçlanmaktadır. Missed abortusun etyolojisi kesin olarak bilinmemektedir. Literatürde sınırlı sayıda çalışmada ortalama platelet hacmi (MPV), platelet dağılım genişliği (PDW), plateletrikt (PCT)’in missed abortusta arttığı bildirilmiştir. Çalışmalardaki olgu sayısı az ve sonuçları tutarsızdır. Literatürde, missed abortusta tüm platelet indekslerini değerlendiren bir çalışma bulunmamaktadır. Bu çalışma missed abortusta tüm platelet indekslerini değerlendiren literatürdeki en geniş seridir.

Yöntemler: Bu retrospektif olgu-kontrol çalışmasında, missed abortus tanısı alan hastaların tam kan sayımı parametreleri karşılaştırıldı. Çalışmada toplam 500 olgunun missed abortus tanısı alan 228’i çalışma grubu, 272 sağlıklı gebe olanı kontrol grubu belirlendi. Çalışmaya 18-45 yaş aralığında, 6-14 gebelik haftasındaki tekil gebeler dahil edildi.

Bulgular: Missed abortus grubunda PDW değeri kontrol grubuna göre yüksek bulunurken (P=0,007); MPV ve PCT değerleri düşük bulundu (sırasıyla P<0,001 ve P=0,008).

Sonuç: Missed abortusta platelet indeksi parametreleri tutarsızdır.

Keywords

• Missed abortus,Platelet indeksleri,Ortalama platelet hacmi,Platelet dağılım genişliği

Association between platelet indices and missed abortion

Abstract

Aim: The incidence of missed abortion is around 15% of clinically diagnosed pregnancies, and the etiology is uncertain. Limited studies in the literature report increased platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT). The number of cases in these studies is low and results are inconsistent. There is no study that investigates all platelet indices. This study has the largest series in the literature and investigates all platelet indices in missed abortion. 

Methods: In this retrospective case-control study, the complete blood count parameters of patients who were diagnosed with missed abortion were examined. Among 500 cases, 228 women with missed abortion constituted the study group, and 272 healthy pregnant women constituted the control group. Women who were 18–45 years of age and 6–14 weeks of gestational age were included. 

Results: In the missed abortion group, PDW value was higher (P=0.007), while platelet MPV and PCT values were lower (respectively P<0.001 and P=0.008) than the control group.

Conclusion: Platelet indices parameters in missed abortion are inconsistent.

Keywords

• Missed abortion,Platelet indices,Mean platelet volume,Platelet distribution width

References

1. 1. Wood SL, Brian PH. Medical management of missed abortion: a randomized clinical trial. Obstet Gynecol. 2002;99(4):563-6.
2. 2. Robertson L, Wu O, Langhorne P, Twaddle S, Clark P, Lowe GD, et al. Thrombophilia in pregnancy: a systematic review. Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study. Br J Haematol. 2006;132(2):171-96.
3. 3. McNamee K, Dawood F, Farquharson R. Recurrent miscarriage and thrombophilia: an update. Curr Opin Obstet Gynecol. 2012;24(4):229-34.
4. 4. Lassere M, Empson M. Treatment of antiphospholipid syndrome in pregnancy-a systematic review of randomized therapeutic trials. Thromb Res. 2004;114(5-6):419-26.
5. 5. Croles FN, Nasserinejad K, Duvekot JJ, Kruip MJ, Meijer K Leebeek FW. Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis. BMJ. 2017,26;359:j4452.
6. 6. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8(1):148-56.
7. 7. Cetin MS, Ozcan Cetin EH, Akdi A, Aras D, Topaloglu S, Temizhan A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiol Pol. 2017;75(10):1005-12.
8. 8. Kosus N, Kosus A, Yildirim M, Duran M, Turhan NO. Mean platelet volume as a marker of thrombosis in patients with missed abortion. Acta Haematol. 2011; 125(4):208-9.

9. 9. Eroglu M, Keskin U, Yildirim AO, Saygi IA, Gun I, Topuz S. Can mean platelet volume predict abortion? Med Glas (Zenica). 2013; 10(2):283-7
10. 10. Hassouna HI. Thrombophilia and hypercoagulability. Med Princ Pract. 2009;18(6):429-40.
11. 11. Sarig G, Younis JS, Hoffman R, Lanir N, Blumenfeld Z, Brenner B. Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril. 2002;77(2):342-7.
12. 12. Askerov R. Embryoscopic diagnostics of endometrial defects in missed abortion after IVF. Gynecol Endocrinol. 2016;32(sup2):62-3.
13. 13. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost. 2003;9(3):177-90.
14. 14. Bain BJ, Bates I. Basic haematological techniques. In: Lewis SM, Bain BJ, Bates I (eds). Dacie and Lewis Practical Haematology, 9th ed. Edinburgh: Churchill Livingstone; 2001:19–46.
15. 15. Akin MN, Kasap B, Yuvaci HU, Turhan N. Association between platelet indices and first trimester miscarriage. Blood Coagul Fibrinolysis. 2016;27(5):526-30.
16. 16. Kaplanoglu M, Yuce T, Bulbul M. Decreased mean platelet volume is associated with the developing stage of fetoplacental unit in spontaneous abortion. Int J Clin Exp Med. 2015;8(7):11301-6.
17. 17. Kara PH, Ünlüer S. Are There any Predictive Values of Mean Platelet Volume (MPV) and MPV/Platelet Count Ratio in Patients with Spontaneous Abortion? Eurasian J Emerg Med. 2017;16:57-61
18. 18. Uysal A, İncebiyik A, Hacıvelioglu S, Gencer M, Gungor A, Cosar E. Is There Any Relationship Between Platelet Functions, Red Cell Distribution Width and Recurrent Pregnancy Loss? J Clin Anal Med. 2015;6(2):149-51.
19. 19. Aynıoglu O, Isık H, Sahbaz A, Harma MI, Isık M,
 Kokturk F. Can Plateletcrit be a Marker for Recurrent Pregnancy Loss? Clinical and Applied Thrombosis/Hemostasis.
2016;22(5):447-52.

20. 20. Al-Aghbary AAR, Almorish MAW, Jaffar DWM, Kahiry WMA. Platelet indices in evaluation of patients with recurrent pregnancy loss. Asian Pacific Journal of Reproduction, 2018;8:15-8.
21. 21. Yilmaz M, Delibas IB, Isaoglu U, Ingec M, Borekci B, Ulug P. Relationship between mean platelet volume and recurrent miscarriage: a preliminary study. Arch Med Sci. 2015;11(5):989-93.
22. 22. Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ. 1989;26;299(6698):541-5.