Evaluation Of The Role Of Complete Blood Count Indices To Predict The Risk Of Pre-Eclampsia

Öz

Aim: To compare the complete blood count CBC indices in the mild preeclamptic, severe preeclamptic and healthy normotensive pregnant women to evaluate whether these parameters have a predictive and prognostic significance in determining the risk and the severity of preeclampsia PE .Material and Methods: A retrospective case-control study was designed including the patient population n= 187 composed of 39 % 19.7 severe PE, 55 % 27.8 mildPE, 104 % 52.5 healthy normotensive singleton pregnant women for controls. The hematocrit Hct , hemoglobin Hb , leukocyte count, platelet count PC , mean platelet volume MPV , platelet distribution width PDW , PC/MPV ratio, systemic inflammatory markers including neutrophil/lymphocyte ratio NRL , platelet/lymphocyte ratio PRL , platelet/ neutrophil PRN ratio were recorded.Results: In comparison of the preeclamptic patients with controls; there was statistically significant difference in MPV p=0.012, p

Anahtar Kelimeler

• Preeclampsia,CBC indices,MPV,PDW,PC/MPV ratio

Tam Kan Sayımı Parametrelerinin Pre-Eklampsi Riskini Öngörmedeki Rolünün Değerlendirilmesi

Öz

Amaç: Ağır preeklampsi, hafif preeklampsi ve sağlıklı gebelerde tam kan sayımı parametrelerini karşılaştırarak, bu parametrelerin preeklampsi tanısı ve şiddetini belirlemedeki önemini tespit etmeyi amaçladık.Gereç ve Yöntemler: Retrospektif vaka kontrollü olarak planlanan bu çalışmada; 39 % 19.7 u ağır preeklampsi, 55 % 27.8 i hafif preeklampsi ve 104 % 52.5 ü ise sağlıklı tekiz gebeden oluşan toplam 187 olgu çalışmaya dahil edildi. Hemoglobin Hb , hemotokrit Hct , trombosit sayısı, ortalama trombosit hacmi MPV , trombosit dağılım aralığı PDW , trombosit /MPV oranı, lökosit sayısı ile birlikte sistemik inflamatuar yanıt markırları olannötrofil/lenfosit NLO , trombosit/lenfosit TLO , trombosit /nötrofil TNO oranları kayıt altına alındı.Bulgular: Ağır ve hafif preeklampsi grupları arasında anlamlı farklılık tespit edilmezken, kontrol grubuyla karşılaştırıldığında, MPV preeklamptik grupta anlamlı derecede yüksek tespit edildi p=0.012, p

Anahtar Kelimeler

• Preeklampsi,tam kan sayım parametreleri,MPV,PDW,trombosit/MPV

Kaynakça

1. American College of Obstetricians and Gynecologists ‘Taske Force on Hypertension in Pregnancy’. Hipertension in pregnancy. Obstet Gynecol 2013;122:1122–31.
2. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and other hypertensivedis orders of pregnancy. Best Pract Res Clin Obs- tet Gynaecol 2011;25: 391–403.
3. Burton GJ, Charnock-Jones DS, Jauniaux E. Regulation of vascular growth and function in the human placenta. Reproduction 2009;138:895–902.
4. Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conversion of the maternal spiral ar- teries for uteroplacental blood flow during human pregnancy. Placenta 2009;30:473–82.
5. Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conversion of the maternal spiral ar- teries for uteroplacental blood flow during human pregnancy. Placenta 2009;30:473–82.
6. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: cur- rent concepts. Am J Obstet Gynecol. 1998; 179:1359–1375.
7. Barden A, Graham D, Beilin LJ, et al. Neutrophil CD11B expression and neutrophil activation in pre-eclampsia. Clin Sci (Lond). 1997; 92:37–44.
8. Greer IA, Dawes J, Johnston TA, et al. Neutrophil activation is confined to the maternalcirculation in pregnancy-induced hypertension. Obstet Gynecol. 1991; 78:28–32.

9. Tsukimori K, Maeda H, Ishida K, Nagata H, Koyanagi T, Nakano H. The superoxide generation of neutrophils in normal and preeclamptic preg- nancies. Obstet Gynecol. 1993; 81:536–540.
10. Redman CWG, Sacks GP, Sargent IL. Preeclampsia: an excessive mater- nal inflammatory response to pregnancy. Am J Obstet Gynecol. 1999; 180:499–506.
11. Taylor, RN.; Roberts, JM. Endothelial cell dysfunction. In: Lindheimer, MD.; Roberts, JM.; Cunningham, FG., editors. Hypertensive Disorders in Pregnancy. 2nd ed.Stamford, CT: Appleton&Lange; 1999. p. 395-429.
12. Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Kücük H, Gürsoy S, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerati- ve colitis. J ClinLab Anal 2013; 27: 72-6.
13. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymp- hocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012; 5: 2.
14. Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Proinflammatory cytokines in acute coronary syndromes: from bench to bedside. Cytoki- ne Growth Factor Rev 2006; 17: 225-33.
15. Zahorec R. Ratio of neutrophil to lymphocyte counts—Rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
16. Proctor MJ, Morrison DS, Talwar D, Balmer SM, Fletcher CD, O’Reilly DS, et al. A comparison of inflammation-based prognostic scores in pa- tients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer 2011; 47: 2633-41.
17. Juan P, Stefano G, Antonella S, Albana C. Platelets in pregnancy. J Prenat Med 2011;5:90–2.
18. Tzur T, Sheiner E. Is there an association between platelet count during the first trimester and preeclampsia or other obstetric complications later in pregnancy? Hypertens Pregnancy 2013;32:74–82.
19. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil num- bers account for leukocytosis in women with preeclampsia. Am J Peri- natol. 2009;26:729-32.
20. Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yildiz E, Ozbilgeç S, Kumru S. Mean platelet volume, neutrophil-lymphocyte ratio and plate- let-lymphocyteratio in severe preeclampsia. Ginekol Pol. 2014;85:197- 203.
21. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet den- sity and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30:1113-8.
22. Boriboonhirunsarn D, Atisook R, Taveethamsathit T. Mean platelet volu- me of normal pregnant women and severe preeclamptic women in Siriraj Hospital. J Med Assoc Thai 1995;78:586–9.
23. Dundar O, Yoruk P, Tutuncu L, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in develop- ment of preeclampsia. Prenat Diagn 2008;28:1052–6.
24. Hutt R, Ogunniyi SO, Sullivan MH, Elder MG. Increased platelet volume and aggregation precede the onset of preeclampsia. Obstet Gynecol 1994;83:146–9.
25. Ceyhan T, Beyan C, Başer I, et al. Theeffect of pre-eclampsia on comp- lete blood count, platelet count and mean platelet volume. Ann Hematol 2006;85:320–22.
26. Makuyana D, Mahomed K, Shukusho FD, Majoko F. Liver and kidney function tests in normal and pre-eclamptic gestation–a comparison with non-gestational reference values. Cent Afr J Med 2002;48:55–9.
27. Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy. 2015;34:434-442.
28. RammaW , Buhimschi IA, Zhao G, Dulay AT, Nayeri UA, Buhimschi CS, Ahmed A. The elevation in circulating anti-angiogenic factors is independent of markers of neutrophil activation in preeclampsia. Angiogenesis. 2012;15:333-40.