Could the Ratios of: Platelet to Lymphocyte, Monocyte to Lymphocyte and Neutrophil to Lymphocyte be Markers for Missed Abortion?

Abstract

Background: Abortion is defined as the termination of pregnancy (TOP) before the viability of the foetus.

Objective: This study aimed to evaluate the association of combination of platelet (PLT) to lymphocyte ratio (PLR), monocyte to  lymphocyte ratio (MLR) and neutrophil to lymphocyte ratio (NLR) as markers for predicting missed abortion in 1 st trimester.

Patients and methods: This cross-sectional study was conducted on 92 women who were divided into two groups: group (A) included 46  women diagnosed with missed abortion in the first trimester and group (B) included 46 women with normal pregnancies in the first  trimester as the control group. This study was conducted in Department of Gynecology and Obstetrics, Mansoura University Hospitals,  Mansoura University, Egypt, from July 2021 to December 2023.

Results: Combination of PLR, MLR and NLR had sensitivity (Sn) and  specificity (Sp) of 78.3% and 73.9% respectively to diagnose missed abortion (Area under curve (AUC) = 0.820). A significant difference was  recorded between both groups concerning lymphocytes, monocytes, PLR, MLR and NLR.

Conclusion: The dependence of PLR, MLR,  and NLR on the prediction of missed abortion isn’t certain because of moderate sensitivity and specificity of these ratios. However,  combination of two ratios led to higher increase in sensitivity, specificity and accuracy in predicting missed abortion than using one ratio.  Combination of the three ratios had higher sensitivity and specificity in predicting missed abortion than using two ratios.