Akdaş Reis Yıldız, Varlı Erol Nadi, Özkan Sadullah, Dereli Murat Levent, Akay Arife, Tolunay Harun Egemen, Engin Üstün Yaprak
Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Ankara, Turkey
J Turk Ger Gynecol Assoc. 2024 Mar 6;25(1):38-43. doi: 10.4274/jtgga.galenos.2023.2022-11-5. Epub 2023 Nov 8.
The pathophysiology of uterine scar dehiscence is not yet clear. The aim of this study was to investigate whether preoperative hemogram parameters can be used as predictive markers of uterine scar dehiscence, thus improving prediction and contributing to management of repeat Cesarean section.
Between 2015 and 2020, 36670 (47.6%) cesarean sections were delivered in our hospital and 16943 of them had a previous Cesarean section. All cases of uterine scar rupture detected during Cesarean section were identified, and a total of 40 patients were included after excluding cases with impairment of the systemic inflammatory response (SIR). Controls consisted of 40 randomly selected, age-and body mass index (BMI)-matched patients, and the groups were compared.
Age, BMI, and gravidity were similar (p>0.05). Although the gestational week and Apgar scores were similar between the groups (p>0.05), the birth weight amongst controls was significantly higher than the uterine dehiscence group (p=0.028). Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and other hemogram values were similar in both groups (p>0.05). Mean platelet volume (MPV) in the control group was significantly higher than in the uterine rupture group (p=0.049). Regression analysis found no significant result between hemogram parameters, birth weight, and dehiscence.
In this study, which set out to identify predictors of the risk of uterine scar dehiscence with SIR parameters, only the MPV value was lower in the dehiscence group.
子宫瘢痕裂开的病理生理学尚不清楚。本研究旨在探讨术前血常规参数是否可作为子宫瘢痕裂开的预测指标,从而改善预测并有助于再次剖宫产的管理。
2015年至2020年期间,我院共进行剖宫产36670例(占47.6%),其中16943例有剖宫产史。识别剖宫产术中检测到的所有子宫瘢痕破裂病例,排除全身炎症反应(SIR)受损的病例后,共纳入40例患者。对照组由40例随机选择的年龄和体重指数(BMI)匹配的患者组成,对两组进行比较。
两组患者的年龄、BMI和妊娠次数相似(p>0.05)。虽然两组之间的孕周和阿氏评分相似(p>0.05),但对照组的出生体重显著高于子宫裂开组(p=0.028)。两组的血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值及其他血常规值相似(p>0.05)。对照组的平均血小板体积(MPV)显著高于子宫破裂组(p=0.049)。回归分析发现血常规参数、出生体重与裂开之间无显著结果。
在本研究中,旨在通过SIR参数确定子宫瘢痕裂开风险的预测指标,裂开组仅MPV值较低。