The postpartum uterine ultrasonographic scale in assessment of uterine involution after cesarean section in treated thrombophilia pregnant patients at term

Abstract

Background Pregnancy is a prothrombotic condition which can be abnormally exaggerated in women with thrombophilia. Methods In a prospective study, patients who delivered at term, by cesarean section, between 1 October 2017 and 1 December 2021, who already had a diagnosis of thrombophilia before coming to our hospital, were included in the study group ( n = 80). A similar number of nonthrombophilia patients ( n = 80) without any history of thrombotic events, age‐ and para‐matched with the study group, were included in the control group. The postpartum uterine ultrasonographic scale (PUUS) values, in the first 24–48 h, were correlated with the patients' data. Results The P‐LCR (platelet large cell ratio), was significantly higher in the treated thrombophilia group ( p = 0.042). There was no correlation between PUUS and complete blood count values, coagulation factors, maternal characteristics, or fetal outcomes, except for postpartum neutrophils ( p = 0.047) and postpartum platelet count ( p = 0.046). Conclusions Postpartum uterine involution was not significantly different, after cesarean section, between treated thrombophilia patients and nonthrombophilia patients. Involution correlated only with postpartum neutrophils and postpartum platelet count.

Inflammation Indexes PLR, SII, AISI, MLR, NLPR and MCVL in Peripartum Treated Thrombophilia Patients Undergoing Cesarean Section at Term-STROBE Compliant

“…In a previous article [29], we demonstrated that postpartum uterine involution only correlated with postpartum neutrophil and postpartum platelet counts. Neutrophils and platelet originate from the same bone marrow [30].…”

“…Our hospital cannot supply thrombophilia screening tests; thus, the control group had their blood sent for screening to specialized laboratories, yielding negative results. The exclusion criteria are as follows: patients suffering from thrombocytopenia (n=2), patients with deep vein thrombosis (n=0), and patients with cerebral thrombosis (n=0) [29]. There were no thrombophilia mutations identified in the control group (Table 2).…”

“…In a previous study [29] on the same group of patients, we presented the demographic, maternal and fetal outcomes.…”

“…For this study, the complete blood count values-the first count is obtained postpartum and the last count is obtained antepartum-were considered. Hospital policy requires blood analyses both 24 hours before and after labor [29]. From these values, we calculated inflammation indexes NLR, dNLR, MLR, PLR, SII, SIRI, AISI, MCVL, NLPR, and IIC as follows:…”

“…We also used the nonparametric Mann-Whitney U test and Spearman's correlation. We considered p<0.05 as significant [29].…”