Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in missed abortion

Abstract Objective Missed abortion occurs in ~ 15% of all clinical pregnancies. The pathogenesis is not clearly known. However, defective placentation resulting in maternal systemic inflammatory response is considered responsible for missed abortion. Platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) are increasingly cited parameters of inflammation in the literature. However, no study evaluated the PLR and NLR rates in missed abortions so far. The aim of the present study is to investigate whether complete blood count (CBC) inflammatory parameters such as NLR and PLR are increased in patients with missed abortion. Methods Medical records of 40 pregnant women whose gestation ended in missed abortion at between 6 and14 weeks of gestation and of 40 healthy pregnant women were collected and compared retrospectively. The groups were compared regarding hemoglobin, hematocrit, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), PLR and NLR. Results Platelet distribution width, NLR and PLR values were higher in the missed abortion group compared with the healthy pregnant women group (rates are p = 0.043; p = 0.038; and p = 0.010, respectively). Hematocrit, MPV, and lymphocyte values were found to be lower in the missed abortion group compared with the healthy pregnant women group (p = 0.027, p = 0.044 and p = 0.025, respectively). Conclusion The PDW, NLR and PLR values of the missed abortion group were reported high; and MPV values were reported low in the present study. These findings may help to speculate a defective placentation in the pathogenesis of missed abortion.

Role of serum progesterone in the diagnosis of ectopic pregnancy and missed abortion

Diagnosis of early pregnancy failure [ectopic pregnancy and missed abortion] still challenging even by using of serial B-HCG and ultrasound. Serum progesterone hormone level value is regarded as one of the important diagnostic tools in the diagnosis of many obstetrical and gynecological conditions; one of these is early pregnancy failure. To assess the role of serum progesterone level in early diagnosis of ectopic pregnancy and missed abortion. The study is conducted at Al-Elwiyah Maternity Teaching Hospital throughout the period between [April 2010 -July 2011]. Ninety women participated in the study, they are at their early weeks of gestation [6-10] weeks. Their ages were between 18-40 years. thirty of them served as a control group [normal intrauterine pregnancy] and sixty pregnant women included in the study group and subcategorized into 2 groups. thirty women with suspected sub-acute or chronic cases of ectopic pregnancy according to ultrasound and beta-HCG results and 30 women served as suspected missed abortion. blood samples were taken from the three groups followed by another blood samples after two-day interval to measure of serum progesterone levels. the results were compared among the three groups at first and second readings. p-value, standard deviation and 95% confidence interval calculated and statistically analyzed. P-value of the serial measurements of serum progesterone levels in two-day interval in the three groups was statistically insignificant. while serum progesterone levels of both ectopic pregnancy and missed abortion were greatly lower than serum progesterone levels of normal intrauterine pregnancy in both first and second readings, with statistically significant deference, P-value is. Serum progesterone levels has a useful role in diagnosing ectopic pregnancy and missed abortion

Embarazo triple heterotópico / Triplet heterotopic pregnancy

Se describe un caso de embarazo triple heterotópico, consistente en un embarazo gemelar monocigótico y uno ectópico tubárico, diagnosticado a las 10 semanas de gestación. El embarazo gemelar resultó ser un aborto retenido y el ectópico accidentado

Manejo expectante del aborto retenido / Expectant management of missed abortion

Se analizan 100 casos consecutivos de pacientes portadoras de aborto retenido sometidas a manejo expectante. El promedio de edad de las pacientes es de 29,1 años, el 81 por ciento es multípara y en el 65 por ciento de los casos no estaban usando métodos anticonceptivos en el último año. El valor promedio de hematrocito no varía durante el seguimiento. Los casos se resuelven en un promedio de 12,8 días. Un 42 por ciento de los casos evolucionan como aborto completo y no requieren de instrumentación. Un 43 por ciento de los casos requiere de legrado pero sólo un 7 por ciento precisa de dilatación. El 16 por ciento de los casos presenta algún tipo de complicación pero sólo el 1 por ciento es de gravedad, no atribuible al manejo expectante. Se concluye que el manejo conservador en los casos de aborto retenido representa una buena alternativa al enfoque clásico de dilatación y legrado en pacientes seleccionadas en las cuales se puede lograr un adecuado seguimiento y control posterior

Diagnostico ecografico en el primer trimestre de gestaciòn / Ultrasonographic diagnosis in the first three months of gestation

Se revisaron 102 expedientes ecogràficos correspondientes al primer trimestre de gestaciòn, en el que se pidiò diagnòstico precoz de gestaciòn, amenaza de aborto, aborto incompleto, aborto retenido, embarazo ectòpico y enfermedad trofoblastica, obteniendose una buena correlaciòn ecogràfico anatopatologica