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.