Evaluation of platelet and inflammatory indices in isolated gestational proteinuria in term pregnancies

Evaluation of platelet and inflammatory indices in isolated gestational proteinuria in term pregnancies

Introduction: Isolated gestational proteinuria (IGP) is new onset gestational proteinuria after 20 weeks of gestation in which the pregnancy is to be completed with normal maternal blood pressure and no signs of preeclampsia with no history of hypertension, diabetes, malignancy, autoimmune or kidney disease. IGP can be the first symptom of preeclampsia, however there is no consensus on whether IGP is a mild form of preeclampsia, in which immunologic factors and inflammation take role in pathogenesis. Platelet and inflammatory indices are changed under inflammation as under systemic inflammation neutrophilia, lymphopenia and thrombocytosis and platelet activation occur. Platelet indices are mean platelet volume (MPV) and platelet volume distribution width (PDW). Inflammatory indices include neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio(PLR). This study compared the platelet and inflammatory indices between IGP and healthy pregnancies. Methods: Thirty-two IGP and 60 healthy term pregnancies were recruited. Proteinuria was detected in 24-hours urine sample if proteinuria exceeded 300 mg/day. Platelet and inflammatory indices were obtained and calculated from complete blood count test. The groups were compared with respect to participant characteristics, MPV, PDW, NLR and PLR. p<0.05 was considered statistically significant. Results: : There was no significant difference among the two groups in terms of participant characteristics, pregnancy outcomes. The platelet and inflammatory indices were not significantly different between the groups. Conclusion: Mean platelet volume, PDW, NLR and PLR were not significantly different between healthy and IGP pregnancies. The pathophysiology of IGP is still controversial in the literature, but this study showed that inflammatory status was not different in IGP pregnancies than healthy pregnancies.

___

  • 1. Martin H. Laboratory measurement of urine albumin and urine total protein in screening for proteinuria in chronic kidney disease. Clin Biochem Rev 2011;32:97–102.
  • 2. Tannetta D, Masliukaite I, Vatish M, et al. Update of syncytiotrophoblast derived extracellular vesicles in normal pregnancy and preeclampsia. J Reprod Immunol. 2017;119:98-106.
  • 3. Rezk M, Abo-Elnasr M, Al Halaby A, et al. Maternal and fetal outcome in women with gestational hypertension in comparison to gestational proteinuria: a 3-year observational study. Hypertens Pregnancy 2016;35:181–8.
  • 4. Masuyama H, Suwaki N, Nakatsukasa H, et al. Circulating angiogenic factors in preeclampsia, gestational proteinuria, and preeclampsia superimposed on chronic glomerulonephritis. Am J Obstet Gynecol 2006;194:551–6.
  • 5. American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report ofthe American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;122:1122.
  • 6. Santner-Nanan B, Peek MJ, Khanam R, Richarts L, Zhu E, Fazekas de St Groth B, Nanan R. Systemic increase in the ratio between Foxp3+ and IL-17-producing CD4+ T cells in healthy pregnancy but not in preeclampsia. J Immunol. 2009;183(11):7023-30.
  • 7. Hartley JD, Ferguson BJ, Moffett A. The role of shed placental DNA in the systemic inflammatory syndrome of preeclampsia. Am J Obstet Gynecol. 2015;213(3):268-77.
  • 8. Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Med. 2016;26(2):178-93.
  • 9. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins Obstetrics. ACOG Practice Bulletin No. 203: Chronic Hypertension in Pregnancy. Obstet Gynecol. 2019;133(1):e26-e50
  • 10. Thalor N, Singh K, Pujani M, et al. A correlation between platelet indices and preeclampsia. Hematol Transfus Cell Ther. 2019;41(2):129-133.
  • 11. Bawore, SG, Adissu, W, Niguse, B, et al. A pattern of platelet indices as a potential marker for prediction of pre-eclampsia among pregnant women attending a Tertiary Hospital, Ethiopia: A case-control study. PLOS ONE. 2021;16(11), e0259543.
  • 12. Gogoi P, Sinha P, Gupta B, et al. Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet. 2019;144(1):16-20.
  • 13. Maynard SE, Min JY, Merchan J, et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest. 2003;111(5):649-58.
  • 14. Kattah A, Milic N, White W, et al. Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia. Am J Physiol Regul Integr Comp Physiol. 2017;313(4):R418-R424.
  • 15. Shinar S, Asher-Landsberg J, Schwartz A, et al. Isolated proteinuria is a risk factor for pre-eclampsia: a retrospective analysis of the maternal and neonatal outcomes in women presenting with isolated gestational proteinuria. J Perinatol. 2016;36(1):25-9.
  • 16. Hauspurg A, Jeyabalan A. Postpartum preeclampsia or eclampsia: defining its place and management among the hypertensive disorders of pregnancy. Am J Obstet Gynecol. 2022;226(2S):S1211-S1221.
ACH Medical journal-Cover
  • Başlangıç: 2022
  • Yayıncı: Ankara Şehir Hastanesi
Sayıdaki Diğer Makaleler

The Effect of Ticagrelor on Survival of Skin Flap in Rat Model

Mehmet TAPAN, Ali YILDIRIM, Hasan Murat ERGANİ

The Role Of Psychiatric And Demographic Factors In The Etiology of Hyperemesis Gravidarum

Guldeniz TOKLUCU, Bilge DOĞAN TAYMUR, Arzu TEKİN, Osman Samet GÜNKAYA, Ayşegül BESTEL, Nıyazı TUG

A Retrospective Analysis of Cases of Non-Immune Hydrops Fetalis in A Tertiary Center

Merve ÖZTÜRK AĞAOĞLU, Atakan TANAÇAN, Zahid AĞAOĞLU, Özgür KARA, Dilek SAHİN

Influences on Family Medicine Career Choice: Implications for Healthcare Development

Şeyma Handan DOĞAN, Tarık Eren YILMAZ, Adem ÖZKARA

Management of Non-Surgical Traumatic Facial Nerve Injuries

Burak YAŞAR, Mehmet TAPAN

The Comparison of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin Treatments in Primary Immunodeficiency Diseases

Meltem ÇETİN, Ayşe METİN

The Need for Emergency Case Management in Family Medicine: A Capital City Case

Tuğba YILMAZ, Tarık Eren YILMAZ, Eren USUL

An Ounce of Prevention, a Pound of Passion: Unveiling Medical Students’ Affinity for Family and Community Medicine in Spain

David MİRAUT, Rebeca TENAJAS

The Effect of Preservation of the Bladder Neck on Incontinence Rates in Patients Who Undergo Robot-Assisted Laparoscopic Radical Prostatectomy

Tanju KETEN, Ali Yasin OZERCAN, Burak KÖSEOĞLU, Ahmet Burak YILMAZ, Ünsal EROĞLU, Yalçın KIZILKAN, Melih BALCI, Özer GÜZEL, Yılmaz ASLAN, Cüneyt ÖZDEN, Altuğ TUNCEL

Classification Of Post COVID-19 Pulmonary Findings Evaluated By Computed Tomography

Murathan KÖKSAL, Mehmet KUTLU, Mutlu GÜLBAY