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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(05): 458-466
DOI: 10.1055/s-0042-1743101
Original Article
Obstetrics

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria

Parâmetros hematológicos para prever a gravidade da hiperêmese gravídica e da cetonúria
Mehmet Musa Aslan 
1   Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, School of Medicine, Sakarya University, Sakarya, Turkey
,
Mustafa Taner Yeler 
2   Department of Biochemistry, Muş State Hospital, Muş, Turkey
,
İsmail Bıyık 
3   Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kütahya, Turkey
,
Hilal Uslu Yuvacı 
4   Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
,
Arif Serhan Cevrioğlu 
4   Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
,
Selcuk Özden 
4   Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
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Abstract

Objective Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.

Method A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared.

Results The mean age of the HG group (n = 532) was 26.3 ±  4.1 years, and that of the control group (n = 534) was 25.9 ±  4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8–5.8)/3.2 (2.6–4.0); p < 0.001; and 135.2 ±  30.4/108.9 ±  62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ±  1.9/5.5 ±  2.4; p < 0.001; 3.8(2.8–4.6)/2.9(2.3–3.6); p < 0.001; and 149.9 ±  48.0/135.9 ±  65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients.

Conclusion The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

Resumo

Objetivo A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG.

Método Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria.

Resultados A média de idade do grupo GH (n = 532) foi de 26,3 ±  4,1 anos, e a do grupo de controle (n = 534) foi de 25,9 ±  4,8 anos. Entre as pacientes com HG, 46% (n = 249) tinham cetona(+), 33% (n = 174), cetona(++), e 21% (n = 109), cetona(+ + +). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) foram maiores no grupo HG do que no grupo de controle: 3,8 (2,8–5,8)/3,2 (2,6–4,0); p < 0,001; e 135,2 ±  30,4/108,9 ±  62,2; p < 0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(++ + ) do que nos grupos com cetona(+) e cetona(++): 7,6 ±  1,9/5,5 ±  2,4; p < 0,001; 3,8 (2,8–4,6)/2,9 (2,3–3,6); p < 0,001; e 149,9 ±  48,0/135,9 ±  65,7; p < 0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG.

Conclusão A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

Keywords

hyperemesis gravidarum - ketonuria - hematological parameters

Palavras-chave

hiperêmese gravídica - cetonúria - parâmetros hematológicos

Contributors

All authors contributed to the writing of the article, relevant revision of the intellectual content, and approved the final version submitted for publication.




Publication History

Received: 22 July 2021

Accepted: 19 October 2021

Article published online:
11 April 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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