Abstract
INTRODUCTION: Subclinical inflammation markers play a significant role in hyperemesis gravidarum
(HEG). Simple hematological markers such as mean platelet volume (MPV), platelet distribution
width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW),
plateletcrit (PCT), and platelet-to-lymphocyte ratio (PLR) have been shown to reflect
inflammatory burden and disease activity in several disorders. Ketonuria is a parameter
used in the diagnosis of severe HEG, but its correlation with disease severity remains
controversial. The relationship of subclinical inflammation markers with degree of
ketonuria has not been examined previously. In this study, we aimed to determine the
diagnostic value of these subclinical inflammation markers and the relationship between
these markers and grade of ketonuria in patients with HEG.
MATERIALS AND METHODS: A total of 94 pregnant women with a diagnosis of HEG and 100 gestational age-matched
healthy pregnant women were enrolled in this retrospective study. MPV, PDW, NLR, PLR,
PCT, and ketonuria were calculated and analyzed from complete blood cell counts and
total urine analyses.
RESULTS: Lymphocyte count was significantly higher in the control group (P < 0,001); NLR and PLR values were significantly higher in the HEG group (P < 0,001). Among inflammation markers, RDW increased significantly (P = 0,008) with an increase in ketonuria in patients with HEG. A statistically significant
correlation was found between white blood cell (WBC) and NLR, PLR, PCT. A moderate
uphill relationship was observed between NLR and WBC and a weak uphill linear relationship
was observed between WBC and PLR and between WBC and PCT
CONCLUSIONS: PLR and NLR can be considered effective markers to aid in the diagnosis
of HEG. No marker was found to correlate with ketonuria grade except RDW, although
the relationship of the severity of ketonuria with severity of disease is controversial.
RDW increases as the degree of ketonuria increases.
Key words
Hyperemesis gravidarum - ketonuria - subclinical inflammation