Vol 93, No 9 (2022)
Research paper
Published online: 2022-07-15

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Evaluation of inflammatory markers in threatened abortions and spontaneous abortions

Aysun Tekeli Taskomur1, Sakine Merve Aydın1
Ginekol Pol 2022;93(9):721-727.

Abstract

Objectives: To evaluate the relationship between threatened abortion and inflammation markers such as procalcitonin, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio.

Material and methods: This was a prospective, controlled study. Serum procalcitonin, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) results of 60 threatened abortions were compared with the results of 60 spontaneous abortions and 60 healthy pregnancies. ROC analyses of procalcitonin, NLR and PLR were performed for threatened abortions. In addition, the threatened abortion group with ongoing pregnancy was divided into two groups according to the presence of hemorrhage area in ultrasonography and re-evaluated in terms of serum procalcitonin levels, NLR and PLR.

Results: Procalcitonin and NLR levels were significantly higher in the threatened abortion group than the abortion and control groups (p < 0.05). There was no significant difference between the control and abortion groups. The area under the curve in ROC analysis was within the 95% confidence interval for procalcitonin and NLR and was statistically significant (p < 0.05). Among the abortus imminens, which were divided into two groups according to whether there was hemorrhage area on ultrasonography, procalcitonin, NLR and PLR were higher in patients with bleeding area than without bleeding, but this was not significant (p > 0.05).

Conclusions: There is an association between procalcitonin and NLR and threatened abortion. Procalcitonin and NLR may support the diagnosis of threatened abortion.

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References

  1. Farrell T, Owen P. The significance of extrachorionic membrane separation in threatened miscarriage. Br J Obstet Gynaecol. 1996; 103(9): 926–928.
  2. Uerpairojkit B, Charoenvidhya D, Tannirandorn Y, et al. Sonographic findings in clinically diagnosed threatened abortion. J Med Assoc Thai. 2001; 84(5): 661–665.
  3. Pawelec M, Pałczyński B, Krzemieniewska J, et al. Initiation of preterm labor. Adv Clin Exp Med. 2013; 22(2): 283–288.
  4. Weiss JL, Malone FD, Vidaver J, et al. FASTER Consortium. Threatened abortion: A risk factor for poor pregnancy outcome, a population-based screening study. Am J Obstet Gynecol. 2004; 190(3): 745–750.
  5. Harbarth S, Holeckova K, Froidevaux C, et al. Geneva Sepsis Network. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med. 2001; 164(3): 396–402.
  6. Choi JJ, McCarthy MW. Novel applications for serum procalcitonin testing in clinical practice. Expert Rev Mol Diagn. 2018; 18(1): 27–34.
  7. Akçay Ş, Doğrul I, Sezer S, et al. Role of Procalcitonin in Differential Diagnosis of Pneumonia and Pulmonary Congestion Associated With End-Stage Renal Failure. Exp Clin Transplant. 2016; 14(Suppl 3): 71–73.
  8. Sato S, Sato S, Tsuzura H, et al. Elevated serum procalcitonin levels and their association with the prognosis of patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2020; 32(9): 1222–1228.
  9. Boilard E, Nigrovic PA, Larabee K, et al. Platelets amplify inflammation in arthritis via collagen-dependent microparticle production. Science. 2010; 327(5965): 580–583.
  10. Saraswat L, Bhattacharya S, Maheshwari A, et al. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010; 117(3): 245–257.
  11. Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks' assessment. Prenat Diagn. 2011; 31(1): 3–6.
  12. Oh JW, Park CW, Moon KC, et al. The relationship among the progression of inflammation in umbilical cord, fetal inflammatory response, early-onset neonatal sepsis, and chorioamnionitis. PLoS One. 2019; 14(11): e0225328.
  13. Creamer AW, Kent AE, Albur M. Procalcitonin in respiratory disease: use as a biomarker for diagnosis and guiding antibiotic therapy. Breathe (Sheff). 2019; 15(4): 296–304.
  14. Morley D, Torres A, Cillóniz C, et al. Predictors of treatment failure and clinical stability in patients with community acquired pneumonia. Ann Transl Med. 2017; 5(22): 443.
  15. Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014; 34(4): 263–273.
  16. Schuetz P, Christ-Crain M, Müller B, et al. Procalcitonin in bacterial infections - hype, hope, more or less? Swiss Med Wkly. 2005; 135(31-32): 451–460.
  17. Huang D, Weissfeld L, Kellum J, et al. Risk prediction with procalcitonin and clinical rules in community-acquired pneumonia. Annals of Emergency Medicine. 2008; 52(1): 48–58.e2.
  18. Mollar A, Villanueva MP, Carratalá A, et al. Determinants of procalcitonin concentration in acute heart failure. Int J Cardiol. 2014; 177(2): 532–534.
  19. Brunkhorst FM, Heinz U, Forycki ZF. Kinetics of procalcitonin in iatrogenic sepsis. Intensive Care Med. 1998; 24(8): 888–889.
  20. Paccolat C, Harbarth S, Courvoisier D, et al. Procalcitonin levels during pregnancy, delivery and postpartum. J Perinat Med. 2011; 39(6): 679–683.
  21. Ata N, Kulhan M, Kulhan NG, et al. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekol Pol. 2020; 91(4): 210–215.
  22. Christoforaki V, Zafeiriou Z, Daskalakis G, et al. First trimester neutrophil to lymphocyte ratio (NLR) and pregnancy outcome. J Obstet Gynaecol. 2020; 40(1): 59–64.
  23. Oğlak SC, Aydın MF. Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss? Ginekol Pol. 2020; 91(9): 524–527.
  24. Biyik I, Albayrak M, Keskin F. Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in missed abortion. Rev Bras Ginecol Obstet. 2020; 42(5): 235–239.
  25. Keskin U, Ulubay M, Dede M, et al. The relationship between the VEGF/sVEGFR-1 ratio and threatened abortion. Arch Gynecol Obstet. 2015; 291(3): 557–561.
  26. Vecchié A, Bonaventura A, Carbone F, et al. Antiapolipoprotein A-1 autoantibody positivity is associated with threatened abortion. Biomed Res Int. 2020; 2020: 9309121.
  27. Meng L, Wang Z, Reilly M, et al. Amniotic immune biomarkers as risk factors in women with different symptoms of threatened late miscarriage. Am J Reprod Immunol. 2020; 83(5): e13232.
  28. Pillai RN, Konje JC, Tincello DG, et al. Role of serum biomarkers in the prediction of outcome in women with threatened miscarriage: a systematic review and diagnostic accuracy meta-analysis. Hum Reprod Update. 2016; 22(2): 228–239.
  29. Hanita O, Roslina O, Azlin MI. Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion. Malays J Pathol. 2012; 34(2): 145–151.