JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Evaluation of hemogram parameters in the diagnosis of ectopic pregnancy, early pregnancy loss and threatened miscarriage
Abstract
Aims: In present study, it aimed to analyse the importance and potential use of inflammatory blood parameters in the prediction of threatened miscarriage (TM), early pregnancy loss (EPL) and ectopic pregnancy (EP).
Methods: Between October 2021 and 2023, the demographic data and obstetric histories of a total of 300 patients (n=100 for each group) diagnosed with TM, EPL, and EP at a single center, as well as 100 healthy women with a first-trimester intrauterine pregnancy, were analyzed. Complete blood count data obtained from these participants included. In statistical analyses, the significance level was set at p<0.05.
Results: Although there was no notable discrepancy between the groups with regard to age, gravidity, and gestational week, the EPL cohort exhibited a markedly elevated parity rate (p=0.003). Additionally, notable disparities in platelet-lymphocyte ratio (PLR) were observed between the EPL and TM groups (p=0.021) and between the EP and TM groups (p=0.030). Additionally, monocyte-lymphocyte ratio (MLR) and neutrophil-lymphocyte ratio (NLR) were found to be higher in the EP group compared to the TM and EPL groups (p=0.004 and p=0.001 for MLR; p=0.000 in both comparisons for NLR).
Conclusion: Inflammatory blood parameters namely PLR, MLR, and NLR appear to be significant biomarkers for the diagnosis and management of TM, EPL, and EP. These findings suggest that integrating PLR, MLR, and NLR into obstetric practice could facilitate the early diagnosis and treatment of these complications.

Keywords : Early pregnancy loss, ectopic pregnancy, hematologic markers, inflammation, threatened miscarriage

Download Article


1. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Gynecology. ACOG Practice Bulletin No. 200: early pregnancy loss. Obstet Gynecol. 2018;132(5):e197-e207. doi:10.1097/AOG.0000000000002899
2. Kolte AM, Bernardi LA, Christiansen OB, et al. Terminology for pregnancy loss prior to viability: a consensus statement from the ESHRE early pregnancy special interest group. Hum Reprod. 2015;30(3):495-498. doi:10.1093/humrep/deu299
3. Shorter JM, Atrio JM, Schreiber CA. Management of early pregnancy loss, with a focus on patient-centered care. Semin Perinatol. 2019;43(2): 84-94. doi:10.1053/j.semperi.2018.12.005
4. Pinar MH, Gibbins K, He M, Kostadinov S, Silver R. Early pregnancy losses: review of nomenclature, histopathology, and possible etiologies. Fetal Pediatr Pathol. 2018;37(3):191-209. doi:10.1080/15513815.2018.1455775
5. Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates in the Medicaid population. Am J Obstet Gynecol. 2013;208(4):274.e1-7, doi:10.1016/j.ajog.2012.12.038
6. Varma R, Gupta J. Tubal ectopic pregnancy. BMJ Clin Evid. 2009; 2009:1406.
7. Belics Z, Gérecz B, Csákány MG. Early diagnosis of ectopic pregnancy. Orv Hetil. 2014;155(29):1158-1166. doi:10.1556/oh.2014.29933
8. Paradisi R, Maldini-Casadei M, Boni P, Busacchi P, Porcu E, Venturoli S. T-helper 2-cytokine levels in women with threatened abortion. Eur J Obstet Gynecol Reprod Biol. 2003;111(1):43-49. doi:10.1016/S0301-2115 (03)00119-2
9. ACOG Practice Bulletin No. 200 Summary: early pregnancy loss. Obstet Gynecol. 2018;132(5):1311-1313. doi:10.1097/AOG.0000000000002900
10. ACOG Practice Bulletin No. 135: second-trimester abortion. Obstet Gynecol. 2013;121(6):1394-1406. doi:10.1097/01.AOG.0000431056.79334.cc
11. Doubilet PM, Benson CB, Bourne T, Blaivas M. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 2013; 369(15):1443-1451. doi:10.1056/NEJMra1302417
12. Dosiou C, Giudice LC. Natural killer cells in pregnancy and recurrent pregnancy loss: endocrine and immunologic perspectives. Endocr Rev. 2005;26(1):44-62. doi:10.1210/er.2003-0021
13. Hoffman BL, Schorge JO, Schaffer JI, et al. Williams Gynecology. 2nd ed. New York. McGraw-Hill Medical, 2015.
14. Proctor MJ, Morrison DS, Talwar D, et al. A comparison of inflammation-based prognostic scores in patients with cancer. Eur J Cancer. 2011;47(17):2633-2641. doi:10.1016/j.ejca.2011.03.028
15. de Jager CP, van Wijk PT, Mathoera RB, De Jongh-Leuvenink J, Van Der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care. 2010;14(5):R192. doi:10.1186/cc9309
16. Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol. 2003;23(12):2131-2137. doi:10.1161/01.ATV.0000095974.95122
17. Shaw JL, Dey SK, Critchley HO, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update. 2010; 16(4):432-444. doi:10.1093/humupd/dmp057
18. Lurie S, Rahamim E, Piper I, Golan A, Sadan O. Total and differential leukocyte counts percentiles in normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2008;136(1):16-19. doi:10.1016/j.ejogrb.2006.12.013
19. Christoforaki V, Zafeiriou Z, Daskalakis G, Katasos T, Siristatidis C. First trimester neutrophil to lymphocyte ratio and pregnancy outcome. J Obstet Gynaecol. 2020;40(1):59-64. doi:10.1080/01443615.2019.1606171
20. 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. doi:10.5603/GP.a2020.0082
21. 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. doi:10.1055/s-0040-1709693
22. Kan E. The effect of systemic inflammation markers on predicting pregnancy outcomes in patients admitted to emergency department with threatened miscarriage. Ank Med J. 2019;19(2):337-343. doi:10.17098/amj.576455
23. Bas FY, Tola EN, Sak S, Cankaya BA. The role of complete blood inflammation markers in the prediction of spontaneous abortion. Pak J Med Sci. 2018;34(6):1381-1385. doi:10.12669/pjms.346.15939
24. Onat T, Kırmızı DA, Çaltekin MD, Başer E, Yalvaç ES. Can hematologic inflammation markers be the indicator of early pregnancy loss? J Surg Med. 2020;4(11):952-955. doi:10.28982/josam.736881
25. Ata N, Kulhan M, Kulhan NG, Turkler C. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekol Pol. 2020;91(4):210-215. doi:10.5603/GP.2020.0042
26. Gencdal S, Aydogmus H, Gencdal NK, Destegul E, Ekmekci E. Evaluation of the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with ectopic pregnancies. J Clin Gynecol Obstet. 2019; 8(3):81-84. doi:10.14740/jcgo559
27. Yilmaz DH, Kunt IC, Ozsoy A, Delibas I, Cakmak B, Arici A. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio on the prediction of methotrexate treatment success in tubal ectopic pregnancy. J Contemp Med. 2016;6(1):25-29. doi:10.16899/ctd.07462
28. Donmez E, Arinkan S, Sut H, Iscan R, Vural F. Importance of inflammatory markers in predicting rupture in ectopic pregnancies. EJMO. 2018;2(4):198-202. doi:10.14744/ejmo.2018.91885
29. Ünsal E, Aksaray S, Köksal D, Şipit T. Potential role of interleukin 6 in reactive thrombocytosis and acute phase response in pulmonary tuberculosis. Postgrad Med J. 2005;81(959):604-607. doi:10.1136/pgmj. 2004.030544
30. Eroglu M, Keskin U, Yildirim A, Saygi IA, Gun I, Topuz S. Can mean platelet volume predict abortion? Med Glas (Zenica). 2013;10(2):283-287.
31. Artunc Ulkumen B, Pala HG, Calik E, Koltan SO. Can mean platelet volume and platelet distribution width be possible markers for ectopic pregnancy and tubal rupture? Pak J Med Sci. 2014;30(2):352-355. doi:10. 12669/pjms.302.4177
32. Turgut A, Sak ME, Ozler A, Soydinç HE, Karaçor T, Gul T. Alteration of peripheral blood cells in tubal ectopic pregnancy. Ginekol Pol. 2013; 84(3):193-196. doi:10.17772/gp/1562
33. Yuri Gasparyan A, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58. doi:10.2174/138161211795049804
34. Kara PH, Ünlüer S. Are there any predictive values of mean platelet volume and MPV/platelet count ratio in patients with spontaneous abortion? Eurasian J Emerg Med. 2017;16(2):57-60. doi:10.5152/eajem. 2017.61687
35. 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(7):11301-11305.
36. Çallıoğlu N, Gül DK, Arslan İÖ, Geyikoğlu İ, Demirçivi E. Inflammatory markers in systemic immune-inflammatory index and inflammatory response index to predict early pregnancy loss. Saudi Med J. 2024;45(8): 808. doi:10.15537/smj.2024.45.8.20240404
37. Huang L, Wang J, Yan L, Wang J, Xiong X. Exploring the predictive value of complete blood count inflammatory parameters in early pregnancy for missed abortion. Science Progress. 2025;108(1):368504251324356. doi:10.1177/00368504251324356
38. Dereli ML, Savran Üçok B, Özkan S, et al. The importance of blood-count-derived inflammatory markers in predicting methotrexate success in patients with tubal ectopic pregnancy. Int J Gynaecol Obstet. 2024;167(2):789-796. doi:10.1002/ijgo.15696
39. Erten Ö, Soysal C. Sistemik immün-inflamasyon indeksinin tubal ektopik gebelikteki rolü. KTD. 2024;25(1):70-75. doi:10.18229/kocatepetip.1207403
40. Topkara Sucu S, Dereli ML, Özkan S, Sucu S, Küçükkayıkçı AS, Çağlar A. Association of haematological inflammatory parameters with miscarriages. JGON. 2024;21(2):95-101. doi:10.38136/jgon.1397196
41. Yang S, Wang M, Yang L, Lin N. Diagnostic value of color Doppler ultrasound combined with blood inflammatory markers in threatened abortion and pregnancy outcomes in early pregnancy. Acta Radiologica. 2025:02841851251324923. doi:10.1177/02841851251324923
42. Yazdizadeh M, Hivehchi N, Ghaemi M, et al. Platelet to lymphocyte and neutrophil-to-lymphocyte ratio in the first trimester of pregnancy, are they useful for predicting spontaneous miscarriage? A case-control study. Int J Reprod Biomed. 2023;21(6):463-470. doi:10.18502/ijrm.v21i6.13632
43. Gorkem U, Kan O, Bostancı MO, Taskiran D, Inal HA. Kisspeptin and hematologic parameters as predictive biomarkers for first-trimester abortions. Medeni Med J. 2021;36(2):98-105. doi:10.5222/MMJ.2021.32549
44. Ahmedy IA, Solyman AE, Hosni NM. Role of inflammatory markers in the differential diagnosis of bleeding in early pregnancy. Egyptian J Hospital Med. 2021;85(2):4263-4267. doi:10.21608/ejhm.2021.209049
Article available in :
Volume 6, Issue 3, 2025
Page : 207-212
https://doi.org/10.47582/jompac.1655184
Article Information
Received : 10 Mar 2025
Accepted : 22 Nis 2025
Published : 18 Haz 2025
Corresponding Author :

İsa Temur: Department of Obstetrics and Gynecology, Faculty of Medicine, Niğde Ömer Halisdemir University, Niğde, Turkiye

[email protected]
Citation : Temur İ. Evaluation of hemogram parameters in the diagnosis of ectopic pregnancy, early pregnancy loss and threatened miscarriage. J Med Palliat Care. 2025;6(3):207-212. doi:10.47582/jompac.1655184

Read: 6
Cited: 0
Download : 4
_Footer