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

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?

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.

Keywords:

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

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