The Predictive Value Of NLR, PLR, MPV In Placenta Previa With Placenta Implantation

Objective:Hematological indexes of patients with placenta previa were analyzed to study the diagnostic efficacy of NLR and PLR in placenta previa patients with placental implantation,and a prediction model of placenta previa with placental implantation was established.Methods:A total of 297 patients with placenta previa in the department of obstetrics and gynecology of shanxi Bethune hospital from December 2012 to December 2019 were studied.All patients with placenta previa had their blood collected within a week before delivery.The general data and hematological indexes of placenta previa patients were analyzed retrospectively.The differences of hematological parameters between the implantation and non-implantation groups of placenta previa patients with normal type and placenta previa patients with dangerous type were analyzed.ROC curve area was used to analyze the diagnostic efficacy of NLR and PLR in placenta previa with placental implantation.A predictive model for placental implantation in placenta previa was established by discriminant analysis.Results:1.There were statistically significant differences in lymphocyte number and PLR between the implantation group and the non-implantation group of placenta previa patients(P < 0.05),but no statistically significant differences in NLR between the two groups(P > 0.05).2.There was no difference in hematological indexes between the implanted group and the non-implanted group.3.There were statistically significant differences in neutrophil %,lymphocyte %,lymphocyte number,NLR and PLR between the placental implantation group and the non-implantation group(P < 0.05).The NLR and PLR of patients with common PP placental implantation were higher than those of non-implanted patients,and the lymphocyte count in the implantation group was lower than that in the non-implanted group.4.Neutrophils % predicted that the area under the curve of common placenta previa with placenta implantation was 0.603,the optimal truncation value was 73.65%,and the sensitivity and specificity were 0.754 and 0.452,respectively.The area under the curve of placenta previa with placenta implantation was predicted by NLR to be 0.592,the optimal cut-off value was 3.91,and the sensitivity and specificity were 0.738 and 0.465,respectively.PLR predicted that the area under the curve of placenta previa with placenta implantation was 0.615,and the optimal cut-off value was 135.38.The sensitivity and specificity of placenta implantation were estimated to be 0.607 and 0.631,respectively.5.There was a significant positive correlation between neutrophil % and NLR value,and a moderate positive correlation between neutrophil % and PLR.Lymphocyte % was negatively correlated with NLR and moderately negatively correlated with PLR.6.The discrimination function of placenta previa with placental implantation was as follows: Z implantation =0.838×pregnancy times +2.737×labor times +4.907× lymphocyte count +1.474×NLR+0.09×P-18.811,Z no implantation =0.499× pregnancy times +2.766×labor times +4.757×lymphocyte count +1.352×NLR+0.0819× PLR-15.905.The results showed that 65.1% cases were classified.Conclusion:The NLR and PLR of placenta praevia with placental implantation in the third triplet of pregnancy were higher than that of non-implanted patients,and the indicators of lymphocyte count,NLR and PLR may be valuable predictors of placental implantation in PP patients.