The Role of Preoperative In ammatory Markers in Cervical Cerclage Success | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2025]

Author(s):

1. Gulten Ozgen: Department of Obstetrics and Gynaecology, Health Sciences University, Bursa Yuksek Ihtisas Training and Research Hospital,Bursa,Turkiye

2. Levent Ozgen: Department of Obstetrics and Gynaecology, Medicine Faculty, Bursa Uludag University,Bursa,Turkiye

3. Burcu Dincgez: Department of Obstetrics and Gynaecology, Health Sciences University, Bursa Yuksek Ihtisas Training and Research Hospital,Bursa,Turkiye

4. Berin Ozyamaci: Department of Obstetrics and Gynaecology, Health Sciences University, Bursa Yuksek Ihtisas Training and Research Hospital,Bursa,Turkiye

Abstract:

Objective: To compare the in ammatory markers between therapeutic and emergency cerclage and assess the predictive role of in ammatory markers for the latency period. Study Design: Descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Bursa Yuksek Ihtisas Training and Research Hospital, Turkiye, from January 2016 to September 2022. Methodology: The therapeutic cerclage group (n = 64) included patients with a history of cervical insu ciency, normal prenatal screening test results, and who underwent cerclage based on history indications. The emergency cerclage group (n = 14) included patients with painless cervical dilation in the second trimester or a history of preterm and a short cervix on ultrasonography. Exclusion criteria composed of multiple pregnancies, active uterine contractions, vaginal bleeding, chorioamnionitis, membrane rupture, foetal anomalies, history of conization or abdominal cerclage, and having in ammatory diseasesS.ociodemographic features, perinatal outcomes, and in ammatory markers such as neutrophil-to-lymphocyte ratio, C-reactive protein, and systemic immune-in ammation index were compared. Systemic immune-in ammation index was calculated by formulating the multiplication value of the neutrophil and platelet count divided by the lymphocyte count. Results: The latency period was shorter (5.5 (0-29) vs. 20 (1-31) weeks, p <0.001) in the emergency cerclage group. Neutrophil-tolymphocyte ratio and systemic immune-in ammation index, which are representatives of increased in ammatory state, were signi cantly higher in the emergency cerclage group (p = 0.007 for both). Systemic immune-in ammation index was correlated with cerclage to delivery interval for all patients (r = -0.307, p = 0.006). Also, it predicted neonatal mortality with a cut-o value of 1078.08, 90% sensitivity and 70.59% speci city (AUC = 0.776, p <0.001) and low Apgar scores with 57.1% sensitivity and 74% speci city (AUC = 0.641, p = 0.038). Conclusion: Systemic immune-in ammation index, correlated with cerclage to delivery interval, could be a marker for predicting neonatal mortality and morbidity in cerclage patients.

Page(s): 55-59

DOI: 10.29271/jcpsp.2025.01.55

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 35, Issue: 1, Year: 2025

Keywords:

Cervical Cerclage , Systemic immunein ammation index , In ammatory markers , Perinatal outcomes

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