Araştırma Makalesi
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Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri

Yıl 2021, Cilt: 3 Sayı: 4, 81 - 86, 31.12.2021
https://doi.org/10.46969/ezh.993850

Öz

Amaç: Çalışmamızın amacı fetal distres nedeniyle sezaryen ile doğum yapan term tekil sağlıklı gebelerin doğum öncesi
bakılan kan parametrelerinin spontan vajinal doğum yapan term tekil sağlıklı gebeler ile farklı olup olmadığı ve akut fetal
distresi öngörmedeki yerini araştırmaktır.
Gereç ve Yöntem: Çalışmaya term tekil gebeliği ve herhangi bir hastalığı olmayan, latent fazda spontan doğum eylemi
başlaması nedeniyle doğum salonuna yatırılan ve travay takiplerinde Kategori III fetal kalp atım trasesi (fetal distres) gelişen
124 gebe dahil edildi. Kontrol grubu olarak spontan vajinal doğum gerçekleştirilen 126 sağlıklı term gebe çalışmaya alındı.
Tam kan parametreleri, yaşı, obstetrik öyküsü, gebelik haftası, oksitosin uygulanıp uygulanmadığı, doğum şekli, doğum
kilosu, yenidoğan cinsiyeti, maternal komplikasyonlar, APGAR skoru (1. ve 5. dk), yenidoğan yoğun bakım ünitesine yatış
olup olmadığı incelendi.
Bulgular: Fetal distres gelişen olguların kontrol grubuna göre gravida, parite, yaşayan çocuk sayısı daha az, erkek
yenidoğan sayısı anlamlı yüksek saptandı. Ayrıca 1. ve 5. dk APGAR skorları kontrol grubundan daha düşük olmasına
rağmen Yenidoğan Yoğun Bakım Ünitesi'ne (YYBÜ) yatış oranı farklılık göstermedi. Kontrol grubuna oranla Hematokrit
(Hct), Lenfosit sayısı, ve Ortalama Platelet Hacmi (MPV) daha düşük, nötrofil sayısı, platelet dağılım genişliği (PDW),
nötrofil/lenfosit oranı (NLR) ve platelet/lenfosit oranı (PLR) daha yüksek saptandı.
Sonuç: Eylem öncesi bakılan tam kan sayımında MPV düşüklüğü, PDW, NLR, PLR yüksekliği saptanan gebeler daha yakın
takip edilmeli ve bu olgularda intrapartum akut fetal distres gelişebileceği akılda tutulmalıdır.

Kaynakça

  • Tosun H, Arulkumaran S. Intrapartum fetal surveillance. Curr Obstet Gynecol 2005; 15:18-24.
  • Tokat MA, Okumuş H, Demir N. Elektronik fetal izlem eğitiminin ebe ve hemşirelerin bilgi ve yorumlama becerilerine etkisi. DEUHYO ED 2011; 4:63-66.
  • ACOG. Intrapartum fetal heart rate monitoring: Nomenclature, interpretation and general management principles. ACOG Practice Bulletin No 106. Obstet Gynecol 2009; 114:192-202.
  • Yildirim M, Turkyilmaz E, Avsar AF. Preoperative neutrophil‑to‑lymphocyte ratio has a better predictive capacity in diagnosing tubo‑ovarian abscess. Obstet Gynecol 2009;114:192-202.
  • Torun S, Tunc BD, Suvak B, Yildiz H, Tas A, Sayilir A, et al. Assessment of neutrophil‑lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012; 36:491‑497.
  • Iléana Corbeau, William Jacot, Séverine Guiu. Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review. Cancers (Basel) 2020; 12:958.
  • Liping Wang, Chunyan Wang, Xuqiang Jia, Minghui Yang, Jing Yu Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis. Clinics (Sao Paulo) 2020; 75:e1450.
  • Josee-LyneEthier, Danielle N Desautels, Arnoud J Templeton, Amit Oza, Eitan Amir, Stephanie Lheureux.. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecologic Oncology 2017;(3) 145: 584-94.
  • Nahit Ata, Mehmet Kulhan, Nur Gozde Kulhan, Can Turkler. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekologia Polska 2020; 91:210–5.
  • Qingling Kang, Wei Li, Nan Yu, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A metaanalysis including 3982 patients. Pregnancy Hypertension 2020; 20:111-118.
  • Wenhua Liu, Xiangming Lou, Zhifen Zhang, Yun Chai Qing Yu. Association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume with the risk of gestational diabetes mellitus, Gynecological Endocrinology,2020; 37:2, 105-107
  • Macones GA, Hankins GD, Spong CY, et al. The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring: Update on Definitions, Interpretation, and Research Guidelines. Obstet Gynecol 2008; 112:661.
  • Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY; Intrapartum assesment. Williams Obstetrics 23’ th ed. 2018; 457-484.
  • Enkin M, Keirse MJ, Renfrevv M, et al: A Guide to Effective Care in Pregnancy and Childbirth, 3rd ed. New York, Oxford University Press, 2000
  • Thacker SB, Berkelman RL: Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv 1986; 41:121.
  • Gangwar R, Chaudhary S. Caesarean Section for Foetal Distress and Correlation with Perinatal Outcome. J Obstet Gynaecol India. 2016;66:177-180.
  • Guan P, Tang F, Sun G, Ren W. Prediction of emergency cesarean section by measurable maternal and fetal characteristics. J Investig Med 2020; 68:799-806.
  • Voskamp BJ, Peelen MJCS, Ravelli ACJ, et al. Association between fetal sex, birthweight percentile and adverse pregnancy outcome. Acta Obstet Gynecol Scand. 2020; 99:48-58.
  • Whittaker PG, Macphail S, Lind T. Serial hematologic changes and pregnancy outcome. Obstet Gynecol 1996; 88: 33-39.
  • Ali Yavuzcan, Mete Caglar, Yusuf Ustun, et al. Mean Platelet Volume, Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Severe Preeclampsia. Ginekol Pol 2014; 85:197-203
  • Burak Yücel, Batuhan Ustun. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health Health 2017; 7:29-32.
  • Cenk Gezer, Atalay Ekin, Ibrahim Egemen Ertas, et al. High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekologia Polska 2016; 878: 431–435.
  • Megha Panwar, Archana Kumari, Anand HP, Rashmi Arora, Vishwajeet Singh, Reeta Bansiwal. Raised neutrophil lymphocyte ratio and serum beta hCG level in early second trimester of pregnancy as predictors for development and severity of preeclampsia. Drug Discoveries & Therapeutics. 2019; 13(1):34-37.
  • Emel Kurtoglu, Arif Kokcu, Handan Celik, Migraci Tosun, and Erdal Malatyalioglu. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. J Matern Fetal Neonatal Med 2015; 28:97-99.
  • Salih Serin, Fazıl Avcı, Onder Ercan, Bülent Köstü, Murat Bakacak, Hakan Kıra., Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia?, Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2016; 6:22-25.
  • Mehmet Toptasa, Hilal Asikb, Muhsin Kalyoncuogluc, Esra Cand, Mehmet Mustafa Can. Are Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio Predictors for Severity of Preeclampsia? J Clin Gynecol Obstet 2016;5:27-31.
  • Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18496.
  • H. Yilmaz , H. T. Celik, M. Namuslu, O. Inan, Y. Onaran, F. Karakurt, A. Ayyildiz, M. A. Bilgic, N. Bavbek, A. Akcay. Benefi ts of the Neutrophil-to-Lymphocyte Ratio for the Prediction of Gestational Diabetes Mellitus in Pregnant Women Exp Clin Endocrinol Diabetes 2014; 122: 39–43.
  • Caglayan E, Engin-Ustun Y, Gocmen A, Sarı N, Seckin L, Kara M, Polat M. Is there any relationship between serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum?: J Perinat Med 2016; 44: 315-320.
  • Ersin Çintesun, Serra Akar, Ayhan Gul, et al. Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case–control study. J Lab Physicians 2019;11:149-53.
  • Kan O , Gemici A, Alkilic A , et al. The Effect of Preoperative Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio on Predicting Rupture Risk in Tubal Ectopic Pregnancies. Gynecol Obstet Invest 2019; 84:378-382.
  • Bullens LM, Smith JS, Marieke Truijens SE, van der Hout-van der Jagt, MB, et al. Maternal hemoglobin level and its relation to fetal distress, mode of delivery, and short-term neonatal outcome: a retrospective cohort study. J Matern Fetal Neonatal Med 2020; 33: 3418-3424.
  • MacKenzie IZ, Cooke I. Prospective 12 month study of 30 minute decision to delivery intervals for “emergency” caesarean section. BMJ 2001; 322:1334–1335.
  • Avşar AF, Seçen Eİ, Akçay GF, Keskin HL, Taş EE, Dalgacı AF. The relationship between first-trimester pregnancy-associated plasma protein-A levels and intrapartum fetal distress development. J Turk Ger Gynecol Assoc 2016; 17:139-142.
  • Smith CV, Nguyen HN, Phelan JP, Phelan JP, Paul RH. Intrapartum assessment of fetal well- being: a comparison of fetal acoustic stimulation with acid-base determinations. Am J Obstet Gynecol 1986; 155:726-728.

The role of Mean platelet volume (MPV), Platelet Distribution Width (PDW), Neutrophil‑to‑lymphocyte ratio (NLR), Red Cell Distribution Width (RDW), and Platelet-to- lymphocyte ratio (PLR) in predicting acute fetal distress

Yıl 2021, Cilt: 3 Sayı: 4, 81 - 86, 31.12.2021
https://doi.org/10.46969/ezh.993850

Öz

Aim: Our study aimed to compare complete blood count parameters between term single healthy pregnant women who
had cesarean section due to fetal distress and who had a spontaneous vaginal delivery and investigate the importance of
these variables in predicting acute fetal distress.
Material and Method: The study included 124 term nullipara pregnant women who were admitted to the delivery room
due to the onset of spontaneous labour in the latent phase and who developed Category III fetal heart rate trace (fetal
distress) during labour follow-up. As the control group, 126 healthy nullipara women who had spontaneous vaginal
delivery were included in the study. In addition, blood parameters, age, obstetric history, gestational week, oxytocin
administration status, mode of delivery, birth weight, newborn gender, maternal complications, the APGAR score,
neonatal intensive care unit admission status were examined.
Results: The cases with fetal distress were found to have lower gravida, parity, less alive children, and a significantly
higher number of male newborns than the control group. In addition, although the APGAR scores at the 1st and 5th
minutes in the fetal distress group were lower than the control group, the NICU admission rate was not significantly
different. HCT, lymphocyte count, and MPV were lower, neutrophil count, PDW, NLR, and PLR were higher in the fetal
distress group compared to the control group.
Conclusion: Pregnant women with low MPV, PDW, NLR, and high PLR in complete blood count before the labour should
be followed up closely, and it should be kept in mind that intrapartum acute fetal distress might develop.

Kaynakça

  • Tosun H, Arulkumaran S. Intrapartum fetal surveillance. Curr Obstet Gynecol 2005; 15:18-24.
  • Tokat MA, Okumuş H, Demir N. Elektronik fetal izlem eğitiminin ebe ve hemşirelerin bilgi ve yorumlama becerilerine etkisi. DEUHYO ED 2011; 4:63-66.
  • ACOG. Intrapartum fetal heart rate monitoring: Nomenclature, interpretation and general management principles. ACOG Practice Bulletin No 106. Obstet Gynecol 2009; 114:192-202.
  • Yildirim M, Turkyilmaz E, Avsar AF. Preoperative neutrophil‑to‑lymphocyte ratio has a better predictive capacity in diagnosing tubo‑ovarian abscess. Obstet Gynecol 2009;114:192-202.
  • Torun S, Tunc BD, Suvak B, Yildiz H, Tas A, Sayilir A, et al. Assessment of neutrophil‑lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012; 36:491‑497.
  • Iléana Corbeau, William Jacot, Séverine Guiu. Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review. Cancers (Basel) 2020; 12:958.
  • Liping Wang, Chunyan Wang, Xuqiang Jia, Minghui Yang, Jing Yu Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis. Clinics (Sao Paulo) 2020; 75:e1450.
  • Josee-LyneEthier, Danielle N Desautels, Arnoud J Templeton, Amit Oza, Eitan Amir, Stephanie Lheureux.. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecologic Oncology 2017;(3) 145: 584-94.
  • Nahit Ata, Mehmet Kulhan, Nur Gozde Kulhan, Can Turkler. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss? Ginekologia Polska 2020; 91:210–5.
  • Qingling Kang, Wei Li, Nan Yu, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A metaanalysis including 3982 patients. Pregnancy Hypertension 2020; 20:111-118.
  • Wenhua Liu, Xiangming Lou, Zhifen Zhang, Yun Chai Qing Yu. Association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume with the risk of gestational diabetes mellitus, Gynecological Endocrinology,2020; 37:2, 105-107
  • Macones GA, Hankins GD, Spong CY, et al. The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring: Update on Definitions, Interpretation, and Research Guidelines. Obstet Gynecol 2008; 112:661.
  • Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY; Intrapartum assesment. Williams Obstetrics 23’ th ed. 2018; 457-484.
  • Enkin M, Keirse MJ, Renfrevv M, et al: A Guide to Effective Care in Pregnancy and Childbirth, 3rd ed. New York, Oxford University Press, 2000
  • Thacker SB, Berkelman RL: Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv 1986; 41:121.
  • Gangwar R, Chaudhary S. Caesarean Section for Foetal Distress and Correlation with Perinatal Outcome. J Obstet Gynaecol India. 2016;66:177-180.
  • Guan P, Tang F, Sun G, Ren W. Prediction of emergency cesarean section by measurable maternal and fetal characteristics. J Investig Med 2020; 68:799-806.
  • Voskamp BJ, Peelen MJCS, Ravelli ACJ, et al. Association between fetal sex, birthweight percentile and adverse pregnancy outcome. Acta Obstet Gynecol Scand. 2020; 99:48-58.
  • Whittaker PG, Macphail S, Lind T. Serial hematologic changes and pregnancy outcome. Obstet Gynecol 1996; 88: 33-39.
  • Ali Yavuzcan, Mete Caglar, Yusuf Ustun, et al. Mean Platelet Volume, Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Severe Preeclampsia. Ginekol Pol 2014; 85:197-203
  • Burak Yücel, Batuhan Ustun. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health Health 2017; 7:29-32.
  • Cenk Gezer, Atalay Ekin, Ibrahim Egemen Ertas, et al. High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekologia Polska 2016; 878: 431–435.
  • Megha Panwar, Archana Kumari, Anand HP, Rashmi Arora, Vishwajeet Singh, Reeta Bansiwal. Raised neutrophil lymphocyte ratio and serum beta hCG level in early second trimester of pregnancy as predictors for development and severity of preeclampsia. Drug Discoveries & Therapeutics. 2019; 13(1):34-37.
  • Emel Kurtoglu, Arif Kokcu, Handan Celik, Migraci Tosun, and Erdal Malatyalioglu. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. J Matern Fetal Neonatal Med 2015; 28:97-99.
  • Salih Serin, Fazıl Avcı, Onder Ercan, Bülent Köstü, Murat Bakacak, Hakan Kıra., Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia?, Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2016; 6:22-25.
  • Mehmet Toptasa, Hilal Asikb, Muhsin Kalyoncuogluc, Esra Cand, Mehmet Mustafa Can. Are Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio Predictors for Severity of Preeclampsia? J Clin Gynecol Obstet 2016;5:27-31.
  • Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18496.
  • H. Yilmaz , H. T. Celik, M. Namuslu, O. Inan, Y. Onaran, F. Karakurt, A. Ayyildiz, M. A. Bilgic, N. Bavbek, A. Akcay. Benefi ts of the Neutrophil-to-Lymphocyte Ratio for the Prediction of Gestational Diabetes Mellitus in Pregnant Women Exp Clin Endocrinol Diabetes 2014; 122: 39–43.
  • Caglayan E, Engin-Ustun Y, Gocmen A, Sarı N, Seckin L, Kara M, Polat M. Is there any relationship between serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum?: J Perinat Med 2016; 44: 315-320.
  • Ersin Çintesun, Serra Akar, Ayhan Gul, et al. Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case–control study. J Lab Physicians 2019;11:149-53.
  • Kan O , Gemici A, Alkilic A , et al. The Effect of Preoperative Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio on Predicting Rupture Risk in Tubal Ectopic Pregnancies. Gynecol Obstet Invest 2019; 84:378-382.
  • Bullens LM, Smith JS, Marieke Truijens SE, van der Hout-van der Jagt, MB, et al. Maternal hemoglobin level and its relation to fetal distress, mode of delivery, and short-term neonatal outcome: a retrospective cohort study. J Matern Fetal Neonatal Med 2020; 33: 3418-3424.
  • MacKenzie IZ, Cooke I. Prospective 12 month study of 30 minute decision to delivery intervals for “emergency” caesarean section. BMJ 2001; 322:1334–1335.
  • Avşar AF, Seçen Eİ, Akçay GF, Keskin HL, Taş EE, Dalgacı AF. The relationship between first-trimester pregnancy-associated plasma protein-A levels and intrapartum fetal distress development. J Turk Ger Gynecol Assoc 2016; 17:139-142.
  • Smith CV, Nguyen HN, Phelan JP, Phelan JP, Paul RH. Intrapartum assessment of fetal well- being: a comparison of fetal acoustic stimulation with acid-base determinations. Am J Obstet Gynecol 1986; 155:726-728.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makalesi
Yazarlar

Sezin Ertürk Aksakal 0000-0002-4418-7319

Kadriye Erdoğan 0000-0002-8789-1875

Yaprak Ustun 0000-0002-1011-3848

Yayımlanma Tarihi 31 Aralık 2021
Kabul Tarihi 17 Aralık 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 3 Sayı: 4

Kaynak Göster

APA Ertürk Aksakal, S., Erdoğan, K., & Ustun, Y. (2021). Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, 3(4), 81-86. https://doi.org/10.46969/ezh.993850
AMA Ertürk Aksakal S, Erdoğan K, Ustun Y. Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Türk Kadın Sağlığı ve Neonatoloji Dergisi. Aralık 2021;3(4):81-86. doi:10.46969/ezh.993850
Chicago Ertürk Aksakal, Sezin, Kadriye Erdoğan, ve Yaprak Ustun. “Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), Ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi 3, sy. 4 (Aralık 2021): 81-86. https://doi.org/10.46969/ezh.993850.
EndNote Ertürk Aksakal S, Erdoğan K, Ustun Y (01 Aralık 2021) Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Türk Kadın Sağlığı ve Neonatoloji Dergisi 3 4 81–86.
IEEE S. Ertürk Aksakal, K. Erdoğan, ve Y. Ustun, “Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri”, Türk Kadın Sağlığı ve Neonatoloji Dergisi, c. 3, sy. 4, ss. 81–86, 2021, doi: 10.46969/ezh.993850.
ISNAD Ertürk Aksakal, Sezin vd. “Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), Ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri”. Türk Kadın Sağlığı ve Neonatoloji Dergisi 3/4 (Aralık 2021), 81-86. https://doi.org/10.46969/ezh.993850.
JAMA Ertürk Aksakal S, Erdoğan K, Ustun Y. Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2021;3:81–86.
MLA Ertürk Aksakal, Sezin vd. “Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), Ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, c. 3, sy. 4, 2021, ss. 81-86, doi:10.46969/ezh.993850.
Vancouver Ertürk Aksakal S, Erdoğan K, Ustun Y. Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2021;3(4):81-6.