Sener Sevki, Uysal Gulsum, Adiguzel Cevdet, Okcu Nefise Tanridan
Department of Obstetrics and Gynecology, Adana City Education and Research Hospital, Kışla Mahallesi, Dr. Mithat Özsan Bulvarı, 4522. Sokak No:1, Yüreğir/Adana, Turkey.
Eur J Med Res. 2025 Jun 18;30(1):489. doi: 10.1186/s40001-025-02778-y.
To compare the demographic characteristics, maternal and perinatal outcomes and hemoglobin parameters according to stages diagnosed with placental abruption.
Patients who underwent cesarean delivery due to clinical suspicion of placental abruption after the 20th week of gestation were included in the study. We eliminated patients with persistent hematological disorders, those on anticoagulant medications, and individuals with uterine deformities. Demographic information, body mass index, initial laboratory results, duration of hospitalization, fetal APGAR scores, and transfers to maternal and neonatal critical care units were all documented from the data system. Patients were categorized into categories based on the stages of placental abruption as outlined in the 2022 emergency obstetric care guide. Stage 0: Asymptomatic patient. Stage I: There is vaginal bleeding, clinical pain in abdomen, no signs of maternal shock or fetal distress. Stage II: There may be vaginal bleeding, no maternal shock. Fetal distress is present. Stage III: There may be maternal shock, intrauterine fetal demise is present. Presence of coagulopathy (30%). The patients were categorized as follows: Group 1 stage 0-I; Group 2 stage II; and Group 3 stage III, and the gathered data were compared among the groups.
A total of 150 patients were involved, with 50 patients in group 1. Group 2 comprised 59 patients, whereas Group 3 had 41 patients. Abruptions were most prevalent in group 3. The neutrophil/lymphocyte ratio (NLR) was statistically significantly elevated in groups 2 and 3. The platelet/lymphocyte ratio (PLR) was statistically significantly reduced in group 1. Hemoglobin and fibrinogen levels were deemed statistically significantly reduced in group 3. In group 2, the Apgar scores at 1 min and 5 min were the lowest, and the demand for newborn intensive care was the highest.
The analysis of hemogram parameters at the initial assessment may aid in the diagnosis of abruption, complementing ultrasonography, particularly in cases of early clinical suspicion. We believe that commonly conducted, cost-effective, and straightforward hemogram parameters, when augmented by artificial intelligence, can provide therapeutic support through the interpretation of data such as PLR and NLP in instances of ambiguous laboratory diagnoses, such as placental abruption.
根据胎盘早剥诊断分期比较人口统计学特征、孕产妇和围产期结局以及血红蛋白参数。
纳入妊娠20周后因临床怀疑胎盘早剥而行剖宫产的患者。我们排除了患有持续性血液系统疾病的患者、正在服用抗凝药物的患者以及子宫畸形的患者。从数据系统中记录人口统计学信息、体重指数、初始实验室检查结果、住院时间、胎儿阿氏评分以及转入母婴重症监护病房的情况。根据2022年紧急产科护理指南中概述的胎盘早剥分期将患者分类。0期：无症状患者。Ⅰ期：有阴道出血、腹部临床疼痛，无母体休克或胎儿窘迫迹象。Ⅱ期：可能有阴道出血，无母体休克。存在胎儿窘迫。Ⅲ期：可能有母体休克，存在宫内胎儿死亡。存在凝血功能障碍（30%）。将患者分为以下几组：第1组为0 - Ⅰ期；第2组为Ⅱ期；第3组为Ⅲ期，并对各组收集的数据进行比较。
共纳入150例患者，第1组50例。第2组包括59例患者，第3组有41例患者。胎盘早剥在第3组最为常见。第2组和第3组的中性粒细胞/淋巴细胞比值（NLR）在统计学上显著升高。第1组的血小板/淋巴细胞比值（PLR）在统计学上显著降低。第3组的血红蛋白和纤维蛋白原水平在统计学上被认为显著降低。在第2组中，1分钟和5分钟时的阿氏评分最低，对新生儿重症监护的需求最高。
初始评估时血常规参数分析可能有助于胎盘早剥的诊断，辅助超声检查，特别是在早期临床怀疑的病例中。我们认为，常见的、具有成本效益且简单的血常规参数，在人工智能的辅助下，可在胎盘早剥等实验室诊断不明确的情况下，通过解读PLR和NLP等数据提供治疗支持。
