Eritrosit Dağılım Genişliği ve Ortalama Trombosit Volümünün Lenfosit Sayısına Oranı Missed Abortusu Öngörebilir Mi?

Yıl 2020, Cilt: 7 Sayı: 3, 141 - 144, 29.12.2020

Melike Nur Akın

https://doi.org/10.47572/muskutd.756390

Öz

Missed abortus (MA) yaygın görülen bir gebelik komplikasyonu olmasına karşın patofizyolojisi tam aydınlatılamamıştır. Ortalama trombosit volümü (MPV) ve eritrosit dağılım genişliği (RDW) ilk trimestır düşükleri ve tekrarlayan gebelik kayıpları gibi obstetrik patolojilerle ilişkili bulunmuştur. Biz de RDW ile MPV’nin lenfosite (MPV/L) oranı ve MA arasındaki ilişkiyi araştırdık. Toplamda 230 hasta çalışmaya alındı. Hastalar çalışma grubu olarak missed abortus olan gebeler (n=125) ve kontrol grubu olarak miadında (> 37 gebelik haftası üzeri) sağlıklı doğum yapmış gebeler (n=105) olmak üzere ikiye ayrıldı. MA’lı gebelerin başvuru esnasındaki hemogram parametreleri ve kontrol grubunda olan gebelerin de ilk trimesterde vermiş oldukları hemogram parametreleri çıkartıldı. MPV, RDW, WBC, L/M oranı ve MPV/L oranı seviyeleri MA grubunda kontrol grubuna göre anlamlı derecede yüksekti. Multivaryat lojistik regresyon analizi kullanarak RDW [Olasılık oranı (OR)=1.737, %95 güven aralığı CI=1.3462.242, p <0.001] ve MPV/L oranının [OR=1.518, %95 güven aralığı CI=1.047-2.199, p=0.028] MA'nın bağımsız prediktörleri olduğu saptandı. Çalışmamızda RDW’nin , MA'nın güçlü bir bağımsız belirleyicisi olabileceği görülmüştür. MPV/L oranı da aynı zamanda MA'nın bağımsız bir öngörücüsüdür ve MPV'den daha üstün prediktif değer göstermiştir.

Anahtar Kelimeler

Eritrosit Dağılım Genişliği, Lenfosit, Missed Abortus, Ortalama Trombosit Volümü

Could Red Cell Distribution Width and Mean Platelet Volume to Lymphocyte Ratio Predict Missed Abortion?

Öz

Missed abortion (MA) is a common pregnancy complication; however, the pathophysiology of MA is still not entirely clear. Mean platelet volume (MPV), and red cell distribution width (RDW) have been found to be associated with obstetrics disorders such as first trimester miscarriage and recurrent miscarriage. We evaluated the association between RDW, MPV to lymphocyte (MPV/L) ratio and MA. A total of 230 cases were included in the present study. Patients were selected from women who had missed abortion (n=125) and controls were selected from the women who had given birth at term (> 37 weeks of gestation) to healthy infants (n=105). In all cases, blood samples were drawn at admission before starting any medication. The MPV, RDW, WBC, L/M ratio and MPV/L ratio levels were significantly higher in the MA group than in the control group. Using multivariate logistic regression analysis, we found that RDW [odds ratio (OR)=1.737, 95% confidence interval (CI)=1.346-2.242, p<0.001] and MPV/L ratio [odds ratio (OR)=1.518, 95% confidence interval (CI) =1.047-2.199, p=0.028] were independent predictors of MA. RDW may be a strong independent predictor of MA.MPV/L ratio was also an independent predictor of MA and it showed superior predictive value than MPV.

Anahtar Kelimeler

Lymphocyte, Mean Platelet Volume, Missed Abortion, Red Cell Distribution Width

Kaynakça

• 1. Januiaux E, Burton GJ. Pathophysiology of histological changes in early pregnancy loss. Placenta 2005;26:114-23.
• 2. Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Fertil Steril. 2012;98:1103–11.
• 3. Hu H, Yang H, Yin Z, et al. Chromosome examination of missed abortion patients. Zhonghua Yi Xue Za Zhi. 2015;95:2837–40.
• 4. Askerov R. Embryoscopic diagnostics of endometrial defects in missed abortion after IVF. Gynecol Endocrinol. 2016;32 (suppl 2):62–3.
• 5. Romero Artaza J, Carbia CD, Ceballo MF, Dı´az NB. Red cell distribution width (RDW): its use in the characterization of microcytic and hypochromic anemias. Medicina (B Aires). 1999;59(1):17-22.
• 6. Shehata HA, Ali MM, Evans-Jones JC, Upton GJ, Manyonda IT. Red cell distribution width (RDW) changes in pregnancy. Int J Gynaecol Obstet. 1998;62(1):43-6.
• 7. Yılmaz ZV, Yılmaz E, Küçüközkan T. Red blood cell distribution width: A simple parameter in preeclampsia. Pregnancy Hypertens. 2016;6(4):285-7.
• 8. Dundar O, Pektas MK, Bodur S, Bakır LV, Cetin A. Recurrent pregnancy loss is associated with increased red cell distribution width and platelet distribution width. J Obstet Gynaecol Res. 2015;41(4):551-8.
• 9. Akin MN, Kasap B, Yuvaci HU, Turhan N. Association between platelet indices and first trimester miscarriage. Blood Coagul Fibrinolysis. 2016;27(5):526-30.
• 10. 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.
• 11. Hudzik B, Szkodziński J, Lekston A, Gierlotka M, Poloński L, Gąsior M. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications. 2016;30(6):1097-102.
• 12. Kurtul A, Acikgoz SK. Usefulness of Mean Platelet Volume-to-Lymphocyte Ratio for Predicting Angiographic No-Reflow and Short-Term Prognosis After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction. Am J Cardiol. 2017;120(4):534-41.
• 13. Calleja-Agius J, Jauniaux E, Pizzey AR, Muttukrishna S. Investigation of systemic inflammatory response in first trimester pregnancy failure. Hum Reprod. 2012;27(2):349-57.
• 14. Mollamahmutoğlu L, Kalyoncu S, Engin-Ustün Y, Moraloğlu O, Danişman N, Buyukkagnici U, Deveer R. Troponin I, C-reactive protein and fibrinogen levels in missed abortions. Clin Exp Obstet Gynecol. 2011;38(1):60-2.
• 15. Calleja-Agius J, Muttukrishna S, Pizzey AR, Jauniaux E. Pro- and antiinflammatory cytokines in threatened miscarriages. Am J Obstet Gynecol. 2011;205(1):83.e8-16.
• 16. Paradisi R, Porcu E, Venturoli S, Maldini-Casadei M, Boni P. Maternal serum levels of pro-inflammatory cytokines in missed and threatened abortion. Am J Reprod Immunol. 2003;50(4):302-8.
• 17. Tracey KJ, Wei H, Manogue KR, et al. Cachectin/tumor necrosis factor induces cachexia, anemia, and inflammation. J Exp Med. 1988;167(3):1211-27.
• 18. Nemeth E, Rivera S, Gabayan V, et al. IL-6 mediates hypoferremia of inflammation by inducing the synthesis of the iron regulatory hormone hepcidin. J Clin Invest. 2004;113(9):1271-6.
• 19. Dempsey MA, Flood K, Burke N, et al. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again. Eur J Obstet Gynecol Reprod Biol. 2015;188:61-5.
• 20. Flood K, Peace A, Kent E, et al. Platelet reactivity and pregnancy loss. Am J Obstet Gynecol. 2010;203(3):281.e1-5.
• 21. 21. Hudzik B, Szkodziński J, Lekston A, Gierlotka M, Poloński L, Gąsior M. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications. 2016;30(6):1097-102.