IS HYPEREMESIS GRAVIDARUM AN INFLAMMATORY PROCESS?

Öz

Objective: Hyperemesis gravidarum (HG) is a condition that associated with intractable nausea and vomiting, causing maternal morbidity and mortality and its etiology remains unclear. It is considred that inflammatory processes take place in the etiology of the disease. In our study, we aimed to evaluate white blood cell count (WBC), monocyte to lymphocyte ratio (MLR), C-reactive protein (CRP), and ferritin levels in pregnants that has HG compared with healthy controls.
Methods: We included to our study 99 pregnants that has HG and 101 healty pregnants that has similar characteristics with study group who applied to Samsun Obstetrics and Gynecology Hospital and Health Sciences University Samsun Educational and Research Hospital Obstetrics and Gynecology Department between January 2017 and July 2018. WBC, MLR, CRP and ferritin levels of these pregnants were evaluated retrospectively.
Results: According to our findings pregnants who had HG had higher vomiting count and weight loss than healthy controls (p<0.001; p<0.01). Also gravida (p=0.03), parity (p=0.02), living child (p=0.02) and abort (p=0.01) counts of hyperemesis patients were higher than healty controls. 31.3% (n=31) of HG cases had (+) keton, 26.2% (n=26) had (++) keton and 42.4% (n=42) had (+++) keton in urine. While WBC (p=0.03) and MLR (p=0.001) levels of HG patients were found significantly higher (p<0.05), there was no significant difference between ferritin (p=0.14) and CRP (p=0.34) levels of the groups. Also ferritin (p=0.01) and CRP (p=0.01) levels of keton (+++) cases were found higher than keton (++) cases respectively (p<0.05).
Conclusion: The WBC and MLR levels were detected higher in HG group in our study which supports the idea that HG has inflammatory background, but we consider that studies which are prospective and have larger sampling would contribute to the literature about the issue.

Anahtar Kelimeler

• Hyperemesis garvidarum,inflammation,white blood cell count,monocyte to lymhocyte ratio,C-reactive protein

HİPEREMEZİS GRAVİDARUM İNFLAMATUAR BİR SÜREÇ Mİ?

Öz

Amaç: Hiperemezis gravidarum (HG), inatçı bulantı kusmayla seyreden, maternal morbidite ve mortaliteye neden olabilen etiyolojisi tam olarak ortaya konulamamış bir durumdur. Hastalığın etiyolojisinde enflamatuar süreçlerin yer aldığı düşünülmektedir. Biz de çalışmamızda HG tanısı alan ve sağlıklı gebelerde enflamatuar belirteçler olan beyaz küre sayısı (BK), monosit/lenfosit oranı (MLR), C-reaktif protein (CRP) ve ferritin düzeylerini değerlendirmeyi amaçladık.
Yöntem: Çalışmamıza 2017 Ocak -2018 Temmuz tarihleri arasında Samsun Kadın Hastalıkları ve Doğum Hastanesi ve Sağlık Bilimleri Üniversitesi Samsun Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Bölümü’ne başvuran HG olan 99 gebe ve vaka grubuyla benzer özelliklere sahip sağlıklı 101 gebe dahil edildi. Bu gebelerin BK, MLR, CRP ve ferritin düzeyleri retrospektif olarak değerlendirildi.
Bulgular: Bulgularımıza göre HG görülen gebelerin kusma sayıları, kilo kaybı miktarı daha yüksektir (p<0,001; p<0,01). Ayrıca gravida (p=0,03), parite (p=0,02), yaşayan çocuk (p=0,02) ve abort (p=0,01) sayıları da HG grubunda daha yüksek saptanmıştır (p<0,05). HG olgularının %31,3’ünde (n=31) keton (+) iken, %26,2’sinde (n=31) keton (++), %42,4’sinde (n=42) keton (+++) olarak saptanmıştır. HG olan gebelerde BK (p=0,03) ve MLR (p=0,001) seviyeleri anlamlı olarak daha yüksek saptanırken (p<0,05), ferritin (p=0,14) ve CRP (p=0,34) seviyeleri arasında anlamlı bir fark saptanmadı. Ayrıca keton +++ olan hastalarda ++ olanlara göre ferritin (p=0,01) ve CRP (p=0,01) seviyeleri anlamlı olarak yüksek saptanmıştır (p<0,05).
Sonuç: Çalışmamızda BK ve MLR düzeyleri HG olan hastalarda yüksek saptanmış olup HG’nin enflamatuar bir zemini olduğunu desteklemektedir ancak prospektif daha büyük örneklemle yapılacak çalışmaların konuyla ilgili katkıda bulunacağını düşünmekteyiz.

Anahtar Kelimeler

• Hiperemezis gravidarum,enflamasyon,beyaz küre,monosit/lenfosit oranı,C-reaktif protein

Kaynakça

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