Prognostic Significance of Neutrophil-to-Lymphocyte Ratio for Repeat Cerclage in Women with Prolapsed Membranes

Song, Ji-Eun; Lee, Keun Young; Son, Ga Hyun

doi:10.1155/2018/1507398

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…While in our study, the amniotic membranes of all patients had prolapsed, thus, cervical lengths could not be assessed. Another report demonstrated that the NLR could be used as a reliable factor for predicting pregnancy outcome following RC [19]. However, this study did not come to the same conclusion, possibly due to the different population or limited sample size.…”

Section: Discussioncontrasting

confidence: 62%

Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

Cai

2021

Preprint

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Background: The role of repeat cerclage (RC) as a remedy for patients with prolapsed membranes after prior cerclage remains controversial. We aimed to investigate whether gestational age (GA) could be used as a valuable factor for predicting pregnancy outcome following RC in women with prolapsed membranes after prior cerclage. Methods: We retrospectively investigated the clinical data of 29 patients who underwent RC resulting from prolapsed membrane after prior cerclage. Receiving operating characteristic (ROC) curve analysis and univariate analysis were performed to determine predictive factors. Patients were divided into two groups according to GA at RC, GA<24.2 weeks and GA≥24.2 weeks. Pregnancy outcomes were compared between groups.Results: The mean GA at prior cerclage was 16.5 weeks; mean GA at RC was 23.6 weeks. The mean GA at delivery was 27.8 weeks with a 69.0% neonatal survival rate. ROC curve and univariate analysis demonstrated that GA at RC was significantly predictive for neonatal survival (area under the curve: 0.928; p=0.000). Using a GA cut-off of ≥24.2 weeks at RC, the sensitivity and specificity of predicting neonatal survival were 93.75% and 61.54%, respectively. There was a significant difference in neonatal survival rate between the GA <24.2 weeks group and GA ≥24.2 weeks group (38.5% vs. 93.8%, p=0.003). Kaplan–Meier survival curves showed a lower incidence of neonatal death in the GA ≥24.2 weeks group (6.3%) compared with GA <24.2 weeks group (61.5%, p=0.023).Conclusions: GA could be a valuable factor for predicting pregnancy outcome post-RC in women with prolapsed membrane after prior cerclage.

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Section: Discussioncontrasting

confidence: 62%

Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

Cai

2021

Preprint

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“…Since delivery is a pro-inflammatory process, one can speculate that preterm delivery is also such a process and the neutrophil-lymphocyte ratio may be useful in predicting early delivery. A relationship has been reported between increase in neutrophil-lymphocyte ratio and delivery under 28 gestational weeks in patients with recurrent cervical cerclages ( 22 ). In our study, there was no difference in neutrophil-lymphocyte ratio in the emergency and prophylactic cerclage patients (p=0.196).…”

Section: Discussionmentioning

confidence: 98%

Prevention of preterm delivery by cervical cerclage; a comparison of prophylactic and emergency procedures

Şimşek

Durdağ

et al. 2021

J Turkish German Gynecol Assoc

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Objective: Prophylactic or emergency type cervical cerclage procedures are being used for treatment of cervical insufficiency. The aim was to review and compare the outcomes of these cerclage types and identify factors affecting outcomes. Material and Methods: Retrospective review of seventy-five patients in whom transvaginal cervical cerclage procedures were performed over a seven-year period in a tertiary referral center. Results: Twenty seven of 75 (36%) patients were in the emergency cerclage group and 48 (64%) of them were in the prophylactic group. Mean body mass index (BMI), hospitalization time and gestational week at cerclage were significantly higher, whereas latency period was significantly shorter for the emergency group. Mean gestational ages at delivery were 35.6±4.5 and 33.6±5.9 weeks in the prophylactic and emergency groups, respectively (p=0.117). Delivery rates under 34 th gestational week were 20.8% and 37.0% in the prophylactic and emergency groups, respectively (p=0.175). Birthweight, and delivery ≥34 th gestational week was higher in the prophylactic group, whereas complication rate was higher in the emergency group, but these differences were not significant. High BMI was associated with more deliveries before 34-week in the prophylactic group. Pre-cerclage cervical length was shorter in patients who delivered before 34 gestational weeks at delivery. Conclusion: Prophylactic and emergency cerclage procedures have comparable results regarding gestational week at delivery. High BMI and low pre-cerclage cervical length may have adverse effects on success of cerclage procedures.

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“…In particular, the plasma neutrophil-to-lymphocyte ratio, IGFBP-2, PSG4, and latexin have been proposed as potential biomarkers for noninvasive prediction of poor pregnancy outcomes following rescue cerclage. 14,19,34 In addition to these plasma biomarkers, the present study has shown that plasma IGFBP- studies are needed to investigate whether these plasma biomarkers, in combination with currently available clinical and other laboratory factors, such as cervical dilatation, neutrophil-to-lymphocyte ratio, and AF markers, can significantly improve the risk prediction of SPTB after cerclage. 6,14,35 Noteworthy, this study revealed for the first time that plasma IGFBP-3, MIP-1α, and S100A8/A9 may represent novel independent biomarkers for good prognosis of rescue cerclage in women with CI.…”

Section: Discussionmentioning

confidence: 99%

Inflammation‐related immune proteins in maternal plasma as potential predictive biomarkers for rescue cerclage outcome in women with cervical insufficiency

Kim

Park

Kim

et al. 2022

American J Rep Immunol

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Problem This study aimed to determine whether various novel plasma mediators of immune regulation associated with inflammation could independently predict the clinical outcome of rescue cerclage in patients with cervical insufficiency (CI). Method of study A total of 41 singleton pregnant women (17–25 weeks) who underwent rescue cerclage for CI were retrospectively evaluated. Stored plasma samples were assayed for IGFBP‐1, ‐2, ‐3, IL‐6, latexin, LBP, lipocalin‐2, M‐CSF, MIP‐1α, MMP‐8, ‐9, pentraxin 3, resistin, S100A8, S100A8/A9, thrombospondin‐2, TIMP‐1, and TNFR2 levels. The primary outcome measures were spontaneous preterm birth (SPTB) at < 28 and < 34 weeks after cerclage placement. Results Multivariate Firth's logistic regression analysis revealed that high levels of IGFBP‐3 and S100A8/A9, and low levels of MIP‐1α were significantly associated with SPTB at < 28 weeks after cerclage placement, whereas only low MIP‐1α levels were significantly associated with SPTB at < 34 weeks, even after adjustment for baseline clinical covariates (e.g., cervical dilatation). For the prediction of SPTB at < 28 weeks, the area under the curves (AUC) of IGFBP‐3, MIP‐1α, and S100A8/A9 were of .686, .691, and .693, respectively. Similarly, the AUC of MIP‐1 α was of .659 to predict SPTB at < 34 weeks. Conclusions These findings suggest that plasma IGFBP‐3, MIP‐1α, and S100A8/A9 can represent noninvasive independent biomarkers for identifying women with CI at high risk for SPTB following rescue cerclage. Nonetheless, further in large, multicenter clinical studies should be performed to confirm the clinical value of these biomarkers.

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Prognostic Significance of Neutrophil-to-Lymphocyte Ratio for Repeat Cerclage in Women with Prolapsed Membranes

Cited by 10 publications

References 16 publications

Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

Prevention of preterm delivery by cervical cerclage; a comparison of prophylactic and emergency procedures

Inflammation‐related immune proteins in maternal plasma as potential predictive biomarkers for rescue cerclage outcome in women with cervical insufficiency

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