Article

Alteration of peripheral blood cells in tubal ectopic pregnancy

Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey.
Ginekologia polska (Impact Factor: 0.68). 03/2013; 84(3):193-6. DOI: 10.17772/gp/1562
Source: PubMed

ABSTRACT To investigate whether mean platelet volumes and leukocyte counts are altered significantly in patients with tubal ectopic pregnancy (TEP).
Retrospective analysis of mean platelet volumes and leukocyte counts of 138 TEP patients, diagnosed between 2005 and 2012, and the control group consisting of 72 pregnants was performed. Patients with TEP were further subdivided into 2 subgroups composed of 72 ruptured and 66 non-ruptured cases. Statistical analysis was performed using the Kruskal-Wallis and the Mann-Whitney U tests.
Mean platelet volume was found to be larger in patients with TEP (whether ruptured or non-ruptured) when compared to controls (p = 0.007). However no significant difference could be observed between the ruptured or non-ruptured cases (p = 0.89). With respect to leukocytosis, the TEP group with tubal rupture had significantly higher white blood cell numbers when compared to the non-ruptured TEP and the control groups (p = 0.022 and p < 0.007, respectively).
Mean platelet volume seems to be higher in ectopic pregnancy and this finding evokes a possible role of increased platelet activity in the pathophysiology Leukocytosis may occur more apparently in EP cases with tubal rupture. However, further prospective, controlled and with a larger sample size studies must be conducted to find clues on the correlation between the clinical entities and laboratory findings.

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    • "Vagdatli et al. showed an increase in MPV over time and a decrease in PDW levels.8 The time period between the blood sampling and sample analyzing affects the levels of platelet indices leading to unreliable results.4 In emergent conditions such as in ectopic pregnancies, the blood samples are analyzed immediately. "
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    ABSTRACT: Objective: We aimed to evaluate the alterations in serum levels of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) in ectopic pregnancy (EP) and discuss the mechanism of the alterations in MPV and PDW. Methods: This retrospective evaluation of 153 tubal EP patients (39 ruptured and 114 non-ruptured) admitted to our clinic between 2009 and 2013 and 67 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet level, MPV, PDW was analyzed. Results: MPV was lower in the EP, especially in ruptured EP, compared to control group. However, no significant difference could be found between the groups (p=0.616). PDW was higher in the EP, especially in ruptured EP, compared to control group, however there was no statistical difference between the three groups (p=0.451). Platelet counts were significantly lower in ruptured EP compared to non-ruptured ectopic pregnancies and control groups (p=0.005). Conclusions: MPV seems to be lower in ruptured EP suggesting the possible high grade inflammation in pathology. Platelet counts tend to be lower in ruptured EP suggesting the consumption of the platelets at the inflammation site. However, further studies are needed to describe the usefulness of the platelet indices in the diagnosis and clinical follow-up of EP. Our preliminary results show that MPV levels may decrease in the ruptured EP cases. At the same time, PDW levels may increase.
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    ABSTRACT: Ectopic pregnancy (EP) is the major cause of maternal morbidity and is responsible for maternal mortality in the first trimester. In order to reduce undesirable results, it is necessary to find rapid and accurate, non-surgical diagnostic tests for ER The goal of the study was to investigate the differences in complete blood count parameters between tubal EPs and healthy pregnancies in be used in the diagnosis of ectopic pregnancy. White blood cell (WBC), neutrophil, monocyte, lymphocyte, platelet (PLT) counts, mean PLT volume (MPV) and PLT distribution width (PDW) levels in the complete blood count samples have been obtained from subjects with diagnosed tubal EP (n=78; study group) and women with healthy intrauterine gestations (n=79; control group). Statistical comparisons between groups were performed using the t test. PDW levels were found to be significantly higher in the control group than EP (p<0.001). However no differences between the study and control groups with regard to PLT and MPV levels were observed. WBC levels were found to be significantly higher in the EP group as compared to controls (p<0.001). When leukocyte differentials were compared, monocyte counts in the EP group were significantly higher than in controls (p=0.005). No statistically significant differences in neutrophil and lymphocyte values were observed in either group. PDW as an indicator of PLT activation is lower in tubal EP than intrauterine pregnancy so, possibly endometrial invasion in the intrauterine pregnancy needs more PLT activation. Monocyte counts are higher in tubal EP, indicating that monocyte activation in the pathophysiology of EP could be effective in the formation of tubal motility and microenvironment regulation.
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