Abstract
Objective:Ectopic pregnancy (EP) is the major cause of maternal morbidity and mortalityinthe first trimester of pregnancy. EP can be treated either medical or surgical approches. The purpose of our study wasto predict the treatment choice of tubal EP by usinghematologic parameters which are routinely used in clinical practice.Methods:After retrospectively data evaluation was done from Januaryu 2014 to Deceber 201. we had 153 patients with EP. Patientsadmitted to methotrexate (MTX) therapy was Group-1. Patients performed surgerywas Group-II. All patients’ initial values including white blood cell (WBC), hemoglobin (Hgb), mean corpuscular volume (MCV), neutrophil and lymphocyte, neutrophil lymphocyte ratio (NLR), platelet, platelet lymphocyte ratio (PLR), red cell distribution width (RDW), platelet distribution width (PDW) and mean platelet volume (MPV)were recorded and compared between groups.Results:Of 153 EP patients, there were 93 patients in MTX group and 60 patients in surgery group. RDW, MPV were significantly increased in MTX group (p=0.003, p=0.001, p=0.038, respectively). However, no statistically significant difference was observed between the groups in terms of WBC, Hgb, MCV, PLT, PLR, PDW.Conslusion:RDW, MPV values were independently associated with MTX therapy. Hematologic parameters can be helpful in the choice of the EP treatment.
Highlights
Implantation of the fertilized ovum outside the uterine cavity is considered as ectopic pregnancy and its prevelance is 1 to 2 percent of all pregnancies.[1]
The major finding of our study is that higher red cell distribution width (RDW), mean platelet volume (MPV) values were independently associated with medical (MTX) therapy option versus surgery in stable tubal ectopic pregnancies
There is limited data about hematologic parameters and Ectopic pregnancy (EP). This is the first study in the literature that shows a relationship between RDW and MPV in tubal ectopic pregnancy treated with MTX protocol
Summary
Implantation of the fertilized ovum outside the uterine cavity is considered as ectopic pregnancy and its prevelance is 1 to 2 percent of all pregnancies.[1] Mostly, ectopic pregnancy The most common implantation site of tubal EP is ampulla followed by the isthmus.[2] There are some risk factors for EP such as history of previous ectopic pregnancy, tubal damage due to tubal surgery or infection, smoking and performed assisted reproductive tecniques.[2] Some factors including cytokines, integrines, growth factors or inflammatory modulators may play a role in the pathogenesis of EP These factors may cause impaired transport of embryo to the uterine cavity and lead to premature implantation.[3]
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