Dilek ŞAHİN, Dilek ŞAHİN, Aykan YÜCEL, Özge YÜCEL ÇELİK, Ayşe İSTEK KELEŞ, Gülşah DAĞDEVİREN

Preterm Erken Membran Rüptürü olan Gebelerin Klinik İzleminde Sistemik İnflamatuar Belirteçlerin Rolü

Amaç: Preterm erken membran rüptürü (PEMR ) sonrası, doğuma kadar geçen sürenin belirlenmesinde, Nötrofil -Lenfosit oranı (NLR), Lenfosit- Monosit oranı (LMR), Trombosit-Lenfosit oranı (PLR), Ortalama Trombosit Hacmi (MPV) ve C- reaktif protein (CRP) değerlerinin rolünü araştırmaktır. Gereç ve Yöntem: Çalışmada kullanılan veriler, kurumsal inceleme kurulumuzun onayı alınarak Ocak 2017 ile Aralık 2018 tarihleri arası hastane kayıtlarından toplanmıştır. Aktif doğum eyleminde olmayan, 34 gebelik haftasının altındaki PEMR tanısı alan hastalar çalışmaya dahil edilmiştir. Tüm hastaların CRP, NLR, LMR, PLR ve MPV değerleri, hastalara antibiyotik profilaksisi ve akciğer maturasyonu için betametazon dozu verilmeden, ilk başvuru anında alınan laboratuvar testlerinden elde edilmiştir. Hastalar membran rüptüründen doğuma kadar geçen zamana göre iki gruba ayrılmış; Grup 1'deki hastalar ilk 72 saatte spontan doğum eylemi başlayanlar, Grup 2'deki hastalar ise 72 saatten sonra spontan doğum eylemi başlayanlar olarak tanımlanmıştır. İki grup CRP, NLR, LMR, PLR ve MPV değerleri açısından karşılaştırılmıştır. Bulgular: Çalışmaya kriterleri sağlayan 172 hasta dahil edilmiştir. Grup 1’de Grup 2’ye göre CRP (ortanca değerler sırasıyla 1,08 ve 0,75 (p =0,012)) ve NLR (ortanca değerleri sırasıyla 6,68 ve 4,74 (p =0,001)) daha yüksek saptanırken, LMR (ortanca değerler sırasıyla 3,00 ve 4,07 (p =0,001)) daha düşük saptanmıştır. Sonuç: PEMR olan hastalarda doğuma kadar geçen sürenin kısa olması yüksek NLR ve CRP ile düşük LMR değerleri ile ilişkilidir. Bu hastalara danışmanlık verilebilmesinde ve hastaların takibiyle ilgili koşulların belirlenmesinde yardımcı olabilir.

The Role of the Systemic İnflammatory Markers in the Clinical Follow-Up of Pregnant Women with Preterm Premature Rupture of Membranes

Objective: To investigate the role of Neutrophil-Lymphocyte ratio (NLR), Lymphocyte-Monocyte ratio (LMR), Platelet-Lymphocyte ratio (PLR), Mean Platelet Volume (MPV), C- reactive protein (CRP) values in determining of the time until delivery after preterm premature rupture of membranes (PPROM). Material and Method: The study data were collected from the hospital records between January 2017 and December 2018. The patients with pprom, below 34 weeks of gestation were included in the study. The CRP, NLR, LMR, PLR and MPV values of the patients were obtained from the blood sample taken at the first admission before antibiotic prophylaxis and betamethasone dose for lung maturation. The patients were divided into two groups; the patients in group 1 were defined as those who started spontaneous delivery in the first 72 hours, and the ones in group 2 as those who started spontaneous delivery after 72 hours. The two groups were compared in terms of their CRP, NLR, LMR, PLR and MPV values. Results: The study included 172 patients who met the inclusion criteria. There was no significant difference between the two groups in terms of PLR and MPV values. CRP, NLR and LMR mean values of group I and group II were calculated as (1.08; 6.68; 3.00 and 0.75; 4.74; 4.07) respectively (p =0.012, p =0.001, p =0.001 ). Conclusion: In the patients with pprom, high NLR, CRP and low LMR values may be helpful to predict delivery within 72 hours and provide appropiate patient counseling. CRP, Inflammatory Marker, Leukocyte, Preterm Premature Rupture of Membranes (PPROM).

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