Methods
Ethical approval was obtained from Alaaddin Keykubat University Local
Ethical Committee (Ethical approval No. 23-10, 18/09/20). Signed
informed consent was obtained from all participants. The study protocols
were designed in accordance with the principles of the Helsinki
Declaration and in adherence to the local guidelines for good clinical
practice. This single-center prospective study was conducted between
September 2020 and December 2020.
The subjects taken all were in the first trimester of their pregnancy.
Signed informed consent was obtained from all participants. The patients
were divided into two groups as RPL group those who had had at least two
abortion in the first trimester (n: 44) and control group those who
continued their pregnancy in a healthy way (n: 60). Blood sample was
taken from the RPL group immediately after their third abortion. The
patients in RPL group were followed routine clinical controls (one week
later after abortion) and the uterine cavity was evaluated with
transvaginal ultrasound. Healthy pregnants were followed up monthly
until labour. RPL was defined as two or more consecutive abortions that
occur before the twentieth gestational week in the absence of a previous
delivery. All participants were non-smokers, non-obese
(<30kg/m2) and did not use vitamin supplementation other than
folic acid.
The exclusion criteria were determined as diabetes, hypertension,
obesity, malignancy, chronic disease, chronic venous insufficiency, and
assisted conception treatments (such as intrauterine insemination, in
vitro fertilization, etc.). Additionally, patients with abortion who did
not meet RPL criteria and patients who were undergoing anticoagulant and
hormone therapy were excluded from the study.
The demographical findings (age, parity, and gravidity) and routine
blood counting parameters [neutrophil (%) and lymphocyte (%) for
obtaining the neutrophil to lymphocyte ratio (%) [NLR], albumin
(g/dL) and fibrinogen (μg/ml) for obtaining fibrinogen to albumin ratio
(%) [FAR], D-dimer (ug/L), mean platelet volume [MPV] (fL),
platelet count (10-3/ uL), and red cell distribution
width [RDW] (standard deviation (SD):fL and coefficient of variation
(CV):%)] were recorded.
Two groups were compared in regards to the recorded parameters.
Thereafter, the RPL patients were divided into two subgroups—one
subgroup of patients who have had two abortions (n:23) and one subgroup
of patients who have had three or more abortions (n:21)—and the
biochemical parameters were analyzed between the subgroups.