The Efficacy of Haematologic Parameters in the  Diagnosis of Missed Abortus: Hematolojik Parametrelerin Missed Abortus Tanısına Etkileri

Gülsüm Uysal; Fulya Çağlı; Eda Ülkü Karakılıç; Hatice Akkaya; Hüseyin Aksoy; Gökhan Açmaz

doi:10.5152/eurjther.2017.227

Authors

Gülsüm Uysal Department of Obstetrics and Gynecology, Adana Numune Training and Research Hospital, Adana https://orcid.org/0000-0002-9381-4892
Fulya Çağlı Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri https://orcid.org/0000-0002-6492-3379
Eda Ülkü Karakılıç Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri https://orcid.org/0000-0002-6625-8544
Hatice Akkaya Department of Obstetrics and Gynecology, Zekai Tahir Burak Womens Health, Training and Research Hospital, Ankara https://orcid.org/0000-0002-9613-1712
Hüseyin Aksoy Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri https://orcid.org/0000-0003-3467-3783
Gökhan Açmaz Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri https://orcid.org/0000-0002-4215-3676

DOI:

https://doi.org/10.5152/eurjther.2017.227

Keywords:

Cancer antigen 125, hematologic parameters, missed abortus, red cell distribution width

Abstract

Objective: The aim of the present study was to investigate the efficacy of hematologic parameters in diagnosing missed abortus (MA). Our second aim was to elucidate the diagnostic value of maternal serum cancer antigen 125 (CA 125) levels in missed abortion.
Methods: Hemoglobin, white blood cell, neutrophil, lymphocyte, and platelet levels; mean corpuscular volume; mean platelet volume (MPV); and red cell distribution width (RDW) in complete blood count samples were obtained from all patients diagnosed with MA (group 1; n=90) and from women with healthy pregnancies (group 2; n=143).
Results: Lymphocyte, platelet, and RDW variables were significantly higher in group 1 (p=0.03, p=0.003, and p=0.005, respectively). High RDW value was independent predictors of MA (OR: 0.810, p<0.05). Mean CA 125 levels between the groups were similar. There was no significant difference in other hematologic laboratory parameters between the groups.
Conclusion: Of all hematologic inflammatory markers, higher RDW value was the only marker associated with MA. RDW might be used as an early promising predictor of MA with low cost. Second, we found that CA 125 and other hematologic inflammatory markers, such as MPV and neutrophil/lymphocyte ratio, are not good markers for predicting MA.

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References

Griebel CP, Halvorsen J, Golemon TB, Day AA. Management of spontaneous abortion. Am Fam Physician 2005; 72: 1243-50.

Zeqiri F, Paçarada M, Kongjeli N, Zeqiri V, Kongjeli G. Missed abortion and application of misoprostol. Med Arh 2010; 64: 151-3.

Clifford K, Rai R, Watson H, Regan L. An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive cases. Hum Reprod 1994; 9: 1328-32.

Aynıoglu O, Isık H, Sahbaz A, Harma MI, Isık M, Kokturk F. Can Plateletcrit be a Marker for Recurrent Pregnancy Loss? Clin Appl Thromb Hemost 2016; 22: 447-52.

Dundar O, Pektas MK, Bodur S, Bakır LV, Cetin A. Recurrent pregnancy loss is associated with increased red cell distribution width and platelet distribution width J Obstet Gynaecol Res 2015; 41: 551-8.

Kurt RK, Aras Z, Silfeler DB, Kunt C, Islimye M, Kosar O. Relationship of red cell distribution width with the presence and severity of preeclampsia. Clin Appl Thromb Hemost 2015; 21: 128-31.

Uysal OK, Duran M, Ozkan B, Sahin DY, Tekin K, Elbasan Z et al. Red cell distribution width is associated with acute myocardial infarction in young patients. Cardiol J 2012; 19: 597-602.

Bischof P. What do we know about the origin of CA 125? Eur J Obstet Gynecol Reprod Biol 1993; 49: 93-8.

Noci I, Biagiotti R, Periti E, Baronci D, Torricelli F, Cefalà L et al. Maternal serum CA 125 levels in first trimester abortion. Eur J Obstet Gynecol Reprod Biol 1995; 60: 35-6.

Kobayashi F, Takashima E, Sagawa N, Mori T, Fujii S. Maternal serum CA125 levels in early intrauterine and tubal pregnancies. Arch Gynecol Obstet 1993; 252: 185-9.

Kutlar I, Aksoy F, Koyluoglu O, Ugur MG, Balat O, Tarakcioglu M. Adenosine deaminase activity in serum and placenta of patients with anembryonic pregnancies and missed abortions. Arch Gynecol Obstet 2005; 272: 124-6.

Tian CF, Kang MH. Common stress and serum cortisol and IL-12 levels in missed abortion. J Obstet Gynaecol 2014; 34: 33-5.

Ozbilgin K, Karaca F, Turan A, Köse C, Vatansever S, Ozcakir T. The higher heparin-binding epidermal growth factor (HB-EGF) in missed abortion. Taiwan J Obstet Gynecol 2015; 54: 13-8.

Makrydimas G, Vandecruys H, Sotiriadis A, Lakasing L, Spencer K, Nicolaides KH. Coelomic fluid leptin concentration in normal first-trimester pregnancies and missed miscarriages. Fetal Diagn Ther 2005; 20: 406-9.

Calleja-Agius J, Jauniaux E, Pizzey AR, Muttukrishna S. Investigation of systemic inflammatory response in first trimester pregnancy failure. Hum Reprod 2012; 27: 349-57.

Fang Y, Yu S, Ma Y, Sun P, Ma D, Ji C, et al. Association of Dll4/notch and HIF-1a -VEGF signaling in the angiogenesis of missed abortion. PLoS One 2013; 8: e70667.

Alonso A, Soto I, Urgelles MF, Corte JR, Rodriguez MJ, Pinto CR. Acquired and inherited thrombophilia in women with unexplained fetal losses. Am J Obstet Gynecol 2002; 187: 1337-42.

Kosus N, Kosus A, Yildirim M, Duran M, Turhan NO. Mean platelet volume as a marker of thrombosis in patients with missed abortion. Acta Haematol 2011; 125: 208-9.

Kaplanoglu M, Yuce T, Bulbul M. Decreased mean platelet volume is associated with the developing stage of fetoplacental unit in spontaneous abortion. Int J Clin Exp Med 2015; 8: 11301-306.

Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47-58.

Yilmaz M, Cimilli G, Saritemur M, Demircan F, Isaoglu U, Kisaoglu A ,et al. Diagnostic accuracy of neutrophil/lymphocyte ratio, red cell distribution width and platelet distribution width in ovarian torsion. J Obstet Gynaecol 2016; 36: 218-22.

Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009; 158: 659-66.

Oylumlu M, Ozler A, Yildiz A, Oylumlu M, Acet H, Polat N, et al. New inflammatory markers in pre-eclampsia: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio. Clin Exp Hypertens 2014; 36: 503-7.

Brumsted JR, Nakajima ST, Badger G, Riddick DH, Gibson M. Serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. J Reprod Med 1990; 35: 499-502.

Osmanağaoğlu MA, Erdoğan I, Eminağaoğlu S, Karahan SC, Ozgün S, Can G, et al. The diagnostic value of beta-human chorionic gonadotropin, progesterone, CA125 in the prediction of abortions. J Obstet Gynaecol 2010; 30: 288-93.

Check JH. Serum CA 125 levels in early pregnancy and subsequent spontaneous abortion. Obstet Gynecol 1990; 76: 894-5.

Hornstein MD, Check JH, Hill JA. Serum CA 125 levels and spontaneous abortion. Am J Obstet Gynecol 1995; 172: 695-9.

Scarpellini F, Mastrone M, Sbracia M, Scarpellini L. Serum CA 125 and first trimester abortion. Int J Gynaecol Obstet 1995; 49: 259-64.

Schmidt T, Rein DT, Foth D, Eibach HW, Kurbacher CM, Mallmann P, et al. Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy. Eur J Obstet Gynecol Reprod Biol 2001; 97: 168-73.