Prediction of preterm premature membrane rupture by the platelet-lymphocyte ratio
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20233308Keywords:
Platelet, Lymphocyte, PROM, Preterm, Inflammatory, BiomarkerAbstract
Background: Premature rupture of membranes is a significant obstetric problem. Evaluating platelet -lymphocyte ratio is expected to illuminate the potential scope of early prediction of PPROM. This study showed that PLR could be a new inflammatory marker for diagnosing preterm PROM.
Methods: The study place was the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh, from May 2019 to October 2019.
Results: It was a case-control study. All mothers were selected by purposive sampling who were PPROM as cases. Age-matched non-PPROM pregnant women at term were also enrolled as control. Afterward, they were scrutinized according to eligibility criteria, and 200 mothers were enrolled. Among them, 100 were cases, and the other 100 were in control. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical, biochemical, and surgical profiles were recorded. Data were compiled, edited, and analyzed. The P-value was determined by the chi-square test (categorical variables) and the student’s t-test (continuous variables). The p-value was significant at <0.05.
Conclusions: The mean age of 100 patients from the case was 24.39±2.81 (age range: 18-36) years, and that of the control, like 100 normal pregnant women, was 24.31±2.34 (age range: 19-35) (p=0.49). The mean parity of case and control were 2.1±0.9 (range: 0-5) and 1.98±0.2 (range: 0-3). The mean gravida of case and control were (3.1±1.2 vs. 3.4±1.4). Platelet count was found to be significantly higher in preterm PROM group (case) than control (241.6±58.7×1000/mm³ vs. 201.7±65.9 ×1000/mm³), p value is <0.001 which is statistically significant. So, PLR might be an excellent inflammatory biomarker to predict preterm PROM.
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References
Cunningham FJ, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL. Preterm labor. In: Williams Obstetrics. 24th ed. New York; Mc Graw Hill Education: 2014;829-61.
Goya M, Bernabeu A, García N, Plata J, Gonzalez F, Merced C, et al. Premature rupture of membranes before 34 weeks managed expectantly: maternal and perinatal outcomes in singletons. J Matern Fetal Neonatal Med. 2013;26:290-3.
Romero R, Ghidini A, Bahado-Singh R. Premature rupture of the membranes. In: Reece EA, Hobbins JC, Mahoney MJ, Petrie RH, eds. Medicine of the fetus and mother. Philadelphia: JB Lippincott; 1992:143.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.
Xia H, Li X, Li X, Liang H, Xu H. The clinical management and outcome of term premature rupture of membrane in East China: results from a retrospective multicenter study. Int J Clin Exp Med. 2015;8:6212-7.
Waters TP, Mercer B. Preterm PROM: prediction, prevention, principles. Clin Obstet Gynecol. 2011;54: 307-12.
Moore RM, Mansour JM, Redline RW, Mercer BM, Moore JJ. The physiology of fetal membrane rupture: Insight gained from the determination of physical properties. Placenta. 2006;27:1037-51.
Toprak E, Bozkurt M, Çakmak BD, Özçimen EE, Silahl M, Yumru AE, et al. Platelet-to-lymphocyteratio: A new inflammatory marker for the diagnosisof preterm premature rupture of membranes. J Turk Ger Gynecol Assoc. 2017;18(3):122-6.
Romero R, Miranda J, Chaemsaithong P, Chaiworapongsa T, Kusanovic JP, Dong Z, et al. Sterile and microbial-associated intraamniotic inflammation in preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med. 2015;28: 1394-409.
Endale T, Fentahun N, Hussen MA. Maternal and fetal outcome in premature rupture of membrane. World J Emerg Med. 2016;7(2):147-52.
Jaffar DW, Rabie MAF. Maternal platelet-to-lymphocyte ratio at delivery can predict
poor neonatal outcome in preterm births. Turk J Obstet Gynecol. 2018;15:254-8
Klement AH, Hadi E, Asali A, Shavit T, Wiser A, Haikin E, et al. Neutrophils to lymphocytes ratio and platelets to lymphocytes ratio in pregnancy: A population study. PloS one. 2018;13:e196.
Kurtoglu E, Kokcu A, Celik H, Tosun M, Malatyalioglu E. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. J Matern Fetal Neonatal Med. 2015;28:97-9.
Köseoğlu SB, Guzel AI, Deveer R, Tokmak A, Engin-Ustun Y, Ozdas S, et al. Maternal serum amyloid A levels in pregnancies complicated with preterm prelabour rupture of membranes. Ginekol Pol. 2014; 85:516-20.
Satar M, Turhan E, Yapicioglu H, Narli N, Ozgunen FT, Cetiner S. Cord blood cytokine levels in neonates born to mothers with prolonged premature rupture of membranes and its relationship with morbidity and mortality. Eur Cytokine Netw. 2008;19:37-41.
Flídrová E, Krejsek J. Innate immunity in pathogenesis of intraamniotic inflammation in pregnancies complicated by preterm premature rupture of membranes. Ceska Gynekol. 2011;76:46-50.
Ekin A, Gezer C, Kulhan G, Avcı ME, Taner CE. Can platelet count and mean platelet volume during the first trimester of pregnancy predict preterm premature rupture of membranes? J Obstet Gynaecol Res. 2015; 41:23-8.