Predictive Value of Complete Blood Countparameters in Placenta Accreta

Abstract

Background: The CBC is easy tool for pregnant women predicting placental invasion anomalies, Numerous studies proposed that cancer cell invasion has several common features with the trophoblast invasion [1] . The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are recent popular markers for inflammatory response and have been applied as predictive markers and prognostic factors in various gynecological cancers [2] . We found in placenta accreta increasing Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio, decreasing Red cell Distribution Width (RDW), Platelet's count. Aim of the Work: Aim of our study is to assess the relationship between complete blood count parameters and placental invasion anomalies. Materials and Methods: Our study is Prospective cohort study done in Labour ward of Ain Shams University Maternity Hospital. From January 2019 to December 2019. On Pregnant women attended Ain Shams University Maternity Hospital with a placenta previa. This study was done after approval of the ethical committee of the department of obstetrics and gynecology, Faculty of Medicine, Ain Shams University. Informed consent was taken from all participants before recruitment in the study, and after explaining the purpose and procedures of the study. The investigator obtained the written, signed informed consent of each subject prior to performing any study specific procedures on the subject. The investigator retained the original signed informed consent form. All laboratory specimens, evaluation forms, reports, video recordings and other records that left the site did not include unique personal to maintain subject confidentiality. The study was based on the investigator self-funding. The main object was presence of significant differences between groups with and without placental invasion anomaly in terms of age, platelet count, mean platelet volume, red cell distribution width and neutrophil to lymphocyte ratio P<0.05 . Conclusion : There are changes in CBC parameters which can predict placental invasion anomalies such as increase in Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and decrease in Red cell Distribution Width (RDW), Platelet's count. The cut point's in predicting placenta accreta by complete blood count are. Mean platelet Volume(MPV) ≥ 8,1fl had the highest diagnostic characteristics. Neutrophil / lymphocyte (N/L) ratio ≥4.1. Red cell Distribution Width (RDW) ≤ 16.6%. Platelet's count ≤ 264.0(x103/mL). Recommendations: In suspected cases of placenta accrete by ultrasound, We recommend to evaluate every change in CBC parameters which can predict placental invasion anomalies eg. Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and Red cell Distribution Width (RDW), Platelet's count.