TY - JOUR T1 - The Clinical Utility of Neutrophil-Based Inflammatory Indices (PIV, DNI, and NPAR) in the Early Prediction of Cesarean Scar Pregnancy TT - Sezaryen Skar Gebeliğinin Erken Prediksiyonunda Nötrofil Bazlı Enflamasyon İndekslerinin (PIV, DNI ve NPAR) Klinik Yararı AU - Okutucu, Gülcan AU - Reyhan Toptaş, Gülnihal AU - Sahin, Dilek PY - 2025 DA - September Y2 - 2025 DO - 10.38136/jgon.1726650 JF - Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi JO - JGON PB - T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi WT - DergiPark SN - 2667-7849 SP - 333 EP - 339 VL - 22 IS - 3 LA - en AB - Objectives: To assess the clinical utility of neutrophil-based inflammatory indices—pan-immune inflammation value (PIV), delta neutrophil index (DNI), and neutrophil percentage-to-albumin ratio (NPAR)—in the early prediction of cesarean scar pregnancy (CSP).Methods: This retrospective case-control study was conducted at Ankara Bilkent City Hospital between January 2023 and March 2025. Thirty-six women diagnosed with CSP and sixty gestational age-matched women undergoing elective termination of early pregnancy were included. Inflammatory markers, including complete blood count parameters, DNI, NPAR, and PIV, were evaluated. Group comparisons were performed using appropriate statistical tests. Receiver operating characteristic (ROC) analysis was used to determine optimal cut-off values for predictive markers.Results: CSP cases demonstrated significantly higher white blood cell (WBC) counts, neutrophil percentages (NEU%), DNI, and PIV values, along with significantly lower lymphocyte counts compared to controls (p < 0.05). No significant difference was observed in NPAR values (p = 0.591). ROC analysis indicated moderate predictive performance for WBC (AUC = 0.707), NEU (%) (AUC = 0.647), and PIV (AUC = 0.647) in predicting CSP.Conclusion: Elevated inflammatory indices such as WBC, NEU (%), DNI, and PIV may serve as adjunctive, accessible biomarkers for early CSP detection. Their integration with imaging modalities could enhance diagnostic accuracy, particularly in settings with limited access to advanced imaging. Larger prospective multicenter studies are warranted to validate these findings and explore their utility in clinical practice. KW - Cesarean scar pregnancy KW - pan-immune inflammation value KW - delta neutrophil index KW - neutrophil percentage-to-albumin ratio KW - inflammatory biomarkers KW - early pregnancy diagnosis N2 - Amaç: Sezaryen skar gebeliğinin (SSG) erken tahmininde, nötrofil bazlı enflamatuvar indekslerden olan pan-immün enflamasyon değeri (PIV), delta nötrofil indeksi (DNI) ve nötrofil yüzdesi-albümin oranının (NPAR) klinik yararını değerlendirmek.Gereç ve Yöntemler: Bu retrospektif vaka-kontrol çalışması, Ocak 2023 ile Mart 2025 tarihleri arasında Ankara Bilkent Şehir Hastanesi'nde gerçekleştirilmiştir. SSG tanısı alan 36 kadın ile vaka grubuyla gebelik yaşı eşleştirilmiş ve erken gebeliği ( CR - 1 Morlando M, Buca D, Timor-Tritsch I, Cali G, Palacios-Jaraquemada J, Monteagudo A, et al. Reproductive outcome after cesarean scar pregnancy: A systematic review and meta-analysis. Acta Obstetricia et Gynecologica Scandinavica. 2020;99(10):1278-89. 2 Tan W, Pang C, Tan H. P04.12: Caesarean section scar pregnancy: case series at a single t UR - https://doi.org/10.38136/jgon.1726650 L1 - https://dergipark.org.tr/tr/download/article-file/4988434 ER -