Öz
Amaç: Preeklampsi, gebeliğin 20. haftasından sonra saptanan; yeni başlangıçlı hipertansiyon ve organ disfonksiyonu ile karakterize, progresif, multisistemik bir hastalık olarak tanımlanmaktadr. Hafif ve şiddetli olmak üzere iki grupta değerlendirilebilen preeklapmsi özellikle şiddetli formunda ciddi maternal, fetal, neonatal morbidite ve mortalite ile ilişkli olabilmektedir. Bununla birlikte preeklampsi etyolojisi ve prediktör faktörleri hala tam olarak aydınlatılabilmiş değildir. Biz çalışmamızda tam kan sayımı parametrelerinin preeklampsi tanısı ve şiddetini belirlemedeki önemini tespit etmeyi amaçladık.
Araçlar ve Yöntemler: Çalışmaya 20 preeklamptik gebe ve 30 preeklampsinin eşlik etmediği sağlıklı gebe dahil edildi. Maternal ve fetal veriler ile birlikte doğum öncesi gebelerden rutin alınan tam kan sayımı parametreleri gruplar arasında karşılaştırıldı. Bu parametreler hemoglobin, trombosit sayısı, ortalama trombosit hacmi, lökosit-lenfosit sayısı ve trombosit /MPV, nötrofil/lenfosit trombosit/lenfosit, trombosit /nötrofil oranlarını kapsamaktadır.
Bulgular: Çalışmamızda değerlendirilen kadınların ortalama yaşları preeklampsi grubunda 30 (±13,5) kontrol grubunda 27(±11) idi. Kan sayımı parametreleri incelendiğinde; preeklampsi grubunda kontrol grubundan daha yüksek hemoglobin düzeyi tespit edilir iken; şiddetli preeklampsi grubunda ortalama trombosit hacminin hafif preklampsi grubu ve kontrol grubundan anlamlı olarak daha yüksek olduğu saptandı.
Sonuç: Çalışmamızda şiddetli preklampsinin eşlik ettiği gebelerde ortalama trombosit hacminin daha yüksek olduğu saptandı. Bununla birlikte, inflamatuar markır olarak kabul edilebilen nötrofil/lenfosit, trombosit/lenfosit oranlarının gruplar arasında fark göstermediği bulundu.
Anahtar Kelimeler
Kaynakça
- KAYNAKÇA 1. Cunningham FG, Lenovo KJ, Bloom SL, Hauth JC,Rouse DJ,Spong CY. Williams Obstetrics. 23.Baskı. New York, USA: McGraw Hill Medical; 2010:706–711.
- 2. Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet. 2019;144(1):16-20.
- 3. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260.
- 4. Croke L. Gestational Hypertension and Preeclampsia: A Practice Bulletin from ACOG. Am Fam Physician. 2019;100(10):649-650.
- 5. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179(5):1359-1375.
- 6. Sargent IL, Germain SJ, Sacks GP, Kumar S, Redman CW. Trophoblast deportation and the maternal inflammatory response in pre-eclampsia. J Reprod Immunol. 2003;59(2):153-160.
- 7. Chua S, Wilkins T, Sargent I, Redman C. Trophoblast deportation in pre-eclamptic pregnancy. Br J Obstet Gynaecol. 1991;98(10):973-979.
- 8. Chandra I, Sun L. Preterm and term preeclampsia: differences in biochemical parameter and pregnancy outcomes. Postgrad Med. 2018;130(8):703-707.
- 9. Odegård RA, Vatten LJ, Nilsen ST, Salvesen KA, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol. 2000;96(6):950-955.
- 10. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for leukocytosis in women with preeclampsia. Am J Perinatol. 2009;26(10):729-732.
- 11. Yavuzcan A, Cağlar M, Ustün Y, ve ark. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197-203.
- 12. Lurie S, Frenkel E, Tuvbin Y. Comparison of the differential distribution of leukocytes in preeclampsia versus uncomplicated pregnancy. Gynecol Obstet Invest. 1998;45(4):229-231.
- 13. Edelstam G, Löwbeer C, Kral G, Gustafsson SA, Venge P. New reference values for routine blood samples and human neutrophilic lipocalin during third-trimester pregnancy. Scand J Clin Lab Invest. 2001;61(8):583-592.
- 14. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-1118.
- 15. Felfernig-Boehm D, Salat A, Vogl SE, ve ark. Early detection of preeclampsia by determination of platelet aggregability. Thromb Res. 2000;98(2):139-146.
- 16.Gezer C, Ekin A, Özeren M, Taner CE, Avcı ME, Doğan A. Erken ve geç preeklampside birinci trimester inflamasyon belirteçlerinin yeri. Perinatoloji Dergisi,2014 22(3), 128-132.
- 17. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32.
- 18. Kirbas A, Ersoy AO, Daglar K, et al. Prediction of Preeclampsia by First Trimester Combined Test and Simple Complete Blood Count Parameters. J Clin Diagn Res. 2015;9(11):QC20-QC23.
- 19. Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia?. J Matern Fetal Neonatal Med. 2019;32(9):1412-1419.
- 20. Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. J Clin Lab Anal. 2012;26(5):403-406. 21. Celikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal. 2013;27(1):72-76.
- 22. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012;5(1):2.
Öz
Aim: Preeclampsia, which detected after the 20th week of pregnancy; is defined as a progressive, multisystemic disease characterized by new-onset hypertension and organ dysfunction. Preeclampsia can be evaluated in two groups as mild and severe, and associated with maternal, fetal, neonatal morbidity and mortality, especially in its severe form. Preeclampsia etiology and predictive factors are still not fully elucidated. In our study, we aimed to determine the importance of blood count parameters in determining the diagnosis and severity of preeclampsia.
Materials and Methods: 20 preeclamptic pregnant women and 30 healthy pregnant women without preeclampsia were included in the study. Along with maternal and fetal data, routine complete blood count parameters taken from before delivery were compared between the groups. These parameters include hemoglobin, thrombocyte number, mean platelet volume, leukocyte-lymphocyte numbers and thrombocyte / MPV, neutrophil / lymphocyte thrombocyte / lymphocyte, thrombocyte / neutrophil ratio.
Results: When blood count parameters are examined; while a higher hemoglobin level was detected in the preeclampsia group than in the control group; It was found that the mean platelet volume in the severe preeclampsia group was significantly higher than the mild pereclampsia group and the control group.
Conclusion: In our study, it was found that the mean platelet volume was higher in pregnant women accompanied by severe preeclampsia. However, it was found that neutrophil / lymphocyte, platelet / lymphocyte ratios, which can be considered as inflammatory markers, did not differ between the groups.
Anahtar Kelimeler
Kaynakça
- KAYNAKÇA 1. Cunningham FG, Lenovo KJ, Bloom SL, Hauth JC,Rouse DJ,Spong CY. Williams Obstetrics. 23.Baskı. New York, USA: McGraw Hill Medical; 2010:706–711.
- 2. Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet. 2019;144(1):16-20.
- 3. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260.
- 4. Croke L. Gestational Hypertension and Preeclampsia: A Practice Bulletin from ACOG. Am Fam Physician. 2019;100(10):649-650.
- 5. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179(5):1359-1375.
- 6. Sargent IL, Germain SJ, Sacks GP, Kumar S, Redman CW. Trophoblast deportation and the maternal inflammatory response in pre-eclampsia. J Reprod Immunol. 2003;59(2):153-160.
- 7. Chua S, Wilkins T, Sargent I, Redman C. Trophoblast deportation in pre-eclamptic pregnancy. Br J Obstet Gynaecol. 1991;98(10):973-979.
- 8. Chandra I, Sun L. Preterm and term preeclampsia: differences in biochemical parameter and pregnancy outcomes. Postgrad Med. 2018;130(8):703-707.
- 9. Odegård RA, Vatten LJ, Nilsen ST, Salvesen KA, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol. 2000;96(6):950-955.
- 10. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for leukocytosis in women with preeclampsia. Am J Perinatol. 2009;26(10):729-732.
- 11. Yavuzcan A, Cağlar M, Ustün Y, ve ark. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekol Pol. 2014;85(3):197-203.
- 12. Lurie S, Frenkel E, Tuvbin Y. Comparison of the differential distribution of leukocytes in preeclampsia versus uncomplicated pregnancy. Gynecol Obstet Invest. 1998;45(4):229-231.
- 13. Edelstam G, Löwbeer C, Kral G, Gustafsson SA, Venge P. New reference values for routine blood samples and human neutrophilic lipocalin during third-trimester pregnancy. Scand J Clin Lab Invest. 2001;61(8):583-592.
- 14. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-1118.
- 15. Felfernig-Boehm D, Salat A, Vogl SE, ve ark. Early detection of preeclampsia by determination of platelet aggregability. Thromb Res. 2000;98(2):139-146.
- 16.Gezer C, Ekin A, Özeren M, Taner CE, Avcı ME, Doğan A. Erken ve geç preeklampside birinci trimester inflamasyon belirteçlerinin yeri. Perinatoloji Dergisi,2014 22(3), 128-132.
- 17. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32.
- 18. Kirbas A, Ersoy AO, Daglar K, et al. Prediction of Preeclampsia by First Trimester Combined Test and Simple Complete Blood Count Parameters. J Clin Diagn Res. 2015;9(11):QC20-QC23.
- 19. Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia?. J Matern Fetal Neonatal Med. 2019;32(9):1412-1419.
- 20. Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. J Clin Lab Anal. 2012;26(5):403-406. 21. Celikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal. 2013;27(1):72-76.
- 22. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012;5(1):2.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Kadın Hastalıkları ve Doğum |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2021 |
| Gönderilme Tarihi | 23 Şubat 2021 |
| Kabul Tarihi | 10 Ağustos 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 18 Sayı: 4 |
