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    The relationship between inflammation markers and ketonuria in hyperemesis gravidarum
    (Wiley, 2021) Soysal, Cenk; Isikalan, Mehmet Murat; Biyik, Ismail; Erten, Ozlem; Ince, Onur
    Objective Hyperemesis gravidarum is an illness that starts in early pregnancy and manifests itself with oral intake problems, electrolyte imbalance, ketonuria, and weight loss. Inflammation is closely associated with the hyperemesis gravidarum, and inflammatory indicators have been studied to understand its pathophysiology. This study investigates the relationship of ketonuria levels with inflammatory markers platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) for hyperemesis gravidarum patients. Material and Methods This retrospective case control study was conducted at Kutahya Medical Sciences University Tertiary Research and Training Hospital between December 2019 and December 2020. A total of 173 pregnancies, 82 of them with hyperemesis gravidarum and 91 of them low-risk pregnancies were included in the study. The patients' demographic profiles and laboratory parameters were recorded. The patients were divided into hyperemesis gravidarum and control groups and the groups were compared for the levels of inflammation markers. For the hyperemesis gravidarum group, the relationship between ketonuria levels and the inflammation severity was investigated. Results MLR, NLR, PLR levels were higher in the hyperemesis gravidarum group than the control group in a statistically significant way (p < 0.001 for all of the comparisons). The hyperemesis gravidarum group was subdivided into four groups based on their ketonuria levels, and their MLR, NLR, PLR levels were compared. The differences between the groups were statistically significant (p < 0.001) and the indicators increased with the ketonuria levels. Finally, ketonuria levels had a positive and significant correlation with MLR (rho =0.67, p < 0.001), PLR (rho =0.67, p < 0.001), and NLR (rho =0.8, p < 0.001). Conclusion Hyperemesis gravidarum patients have higher levels of hematologic inflammation indicators than healthy pregnant patients. For these patients, the levels of the indicators increase with ketonuria levels.
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    Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion
    (Wiley, 2023) Soysal, Cenk; Sari, Hatice; Isikalan, Mehmet Murat; Ozkaya, Eren Berkay; Ulas, Ozlem; Tasci, Yasemin; Keskin, Nadi
    Purpose: Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. Methods: This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count x (neutrophil/lymphocyte). Results: SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 +/- 683 vs. 579 +/- 364 [p < 0.001], 3.3 +/- 2.0 vs. 2.1 +/- 1.1 [p < 0.001], 0.3 +/- 0.1 vs. 0.2 +/- 0.2 [p < 0.001], 9.84 +/- 2.87 vs. 8.6 +/- 1.6 [p < 0.001], 13.9 +/- 1.9 vs. 14.4 +/- 2.3 [p = 0.032] and 0.3 +/- 0.1 vs. 0.2 +/- 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). Conclusion: SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy.
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    The value of measuring cervical length between 24 and 28 weeks of gestation for predicting the risk of late and post-term pregnancy
    (Taylor & Francis Ltd, 2021) Soysal, Cenk; Isikalan, Mehmet Murat
    Objective The aim of this study was to investigate the value of measuring cervical length (CL) between 24 and 28 weeks of gestation for predicting the risk of late and post-term pregnancy. Methods In this prospective longitudinal study, pregnant women whose CL was measured between 24 and 28 weeks were followed until delivery. The CL was adjusted for confounders and the results are presented using odds ratio and receiver operating characteristic curve (ROC). Results A total of 874 women met the inclusion criteria. The median value of CL measured between 24 and 28 weeks was 34.0 mm (30.0-38.0 25%, 75% interquartile range). The risk of late and post-term pregnancy was 5.8 times higher in pregnant women with a CL above 35 mm between the 24 and 28 weeks of gestation (95% CI: 2.65-12.94 adjusted OR = 5.8, p < .001). For pregnancies exceeding the 38th week, it was observed that the duration of the gestation increases as CL values increase. Conclusions In this study, it has been demonstrated that measuring the CL between 24 and 28 weeks of gestation can predict late and post-term pregnancy. Prolonged pregnancy may cause neonatal and fetal complications and anxiety. CL measurement performed in these weeks can help prepare pregnant women for a possible prolonged pregnancy and cope with prolonged pregnancy anxiety.