Reference intervals of complete blood count and coagulation tests in Vietnamese pregnant women.

BACKGROUND: Pregnancy has major effects that make hematology parameters outside of normal reference ranges. Therefore, we conducted this study to establish reference intervals for Vietnamese pregnant women. METHODS: From June 2023 to Augst 2023, blood samples from 879 eligible pregnant women were run on DxH 900 hematology analyzer and ACL TOP 550 coagulation analyzer. The tested parameters are prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), white blood cell (WBC) and its differentials (neutrophils, lymphocytes, monocytes, eosinophils and basophils), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC distribution width (RDW), RBC distribution width standard deviation (RDW-SD), platelet count (PLT), mean platelet volume (MPV). A non-parametric method was used to establish the 2.5th and 97.5th percentile reference intervals. RESULTS: PT, APTT decrease but fibrinogen increases during pregnancy. Physiological adaptations of pregnancy result in a decrease in RBC count, but an increase in WBC count and no changes in platelet count. The reference intervals for PT (seconds), APTT (seconds), fibrinogen (mg/dL), in the first trimester were 10.30-12.88, 25.40-35.46, 280.28-559.00, in the second trimester were 9.80-11.66, 24.05-33.23, 347.75-593.35, in the third trimester were 9.60-11.40, 23.40-31.80, 330.28-628.56, respectively. The reference intervals for main hematology parameters which are WBC (× 109/L), RBC (× 1012/L), HGB (g/dL), HCT (%), PLT (× 109/L) in the first trimester were 6.33-15.24, 3.73-5.32, 10.33-13.95, 32.22-42.29, 169.66-413.88, in the second trimester were 6.99-15.55, 3.33-4.98, 9.71-13.17, 30.26-40.07, 172.34-372.19, in the third trimester were 6.22-14.14, 3.54-4.98, 9.80-13.97, 31.11-42.70, 151.30-417.14, respectively. CONCLUSIONS: Most established referenced intervals from each trimester differ from other trimesters. These trimester-specific reference ranges for Vietnamese pregnant women will aid clinicians in entepreting parameters and help other laboratories adopt these ranges after validating. TRIAL REGISTRATION: This study is registered at www. CLINICALTRIALS: gov as NCT05929326.

Impact of short-term versus longterm topical steroid treatment on 'idiopathic' endothelial cell loss after normal-risk penetrating keratoplasty.

PURPOSE: Chronic endothelial cell loss after penetrating keratoplasty (PK) is suspected to result from a subclinical immune reaction. The aim of this study was to investigate whether the prolonged use of a topical steroid after normal-risk PK has a favourable impact on chronic endothelial cell loss. METHODS: The study included 305 eyes from the prospective Erlangen Normal-risk Keratoplasty Study, with a mean follow-up of 3.1 +/- 0.9 years. Postoperative treatment was initiated with prednisolone acetate 1% eyedrops five times a day and was tapered slowly over the first 6 months. Patients were then randomized into two treatment groups: a short-term group (n = 161), which stopped topical steroid treatment, and a longterm group (n = 144), which continued topical treatment with prednisolone acetate 1% eyedrops once a day until 12 months postoperatively. Endothelial cell counts were determined at each follow-up examination (after 6 weeks, then every 3 months until 2 years, then once a year). RESULTS: Endothelial cell density in the short-term and longterm groups decreased significantly from 1941 +/- 550 cells/mm(2) and 1957 +/- 568 cells/mm(2) to 1535 +/- 535 cells/mm(2) and 1472 +/- 549 cells/mm(2), respectively, from 6 weeks to 2 years postoperatively (p < 0.001). In a linear regression model, cell count in the short-term group decreased by 216 +/- 93 cells/mm(2) and in the longterm group by 206 +/- 111 cells/mm(2) per year. There was no significant difference in endothelial cell loss between the short-term and longterm groups (p = 0.5). CONCLUSIONS: Longterm, low-dose, topical steroid treatment does not seem to prohibit chronic endothelial cell loss after normal-risk penetrating keratoplasty, in contrast to its favourable effect on immunological graft reactions. Our results may indicate that the aetiology of chronic endothelial cell loss is not of inflammatory origin. Further studies are needed to investigate this phenomenon.