Complete blood count parameters in the antepartum diagnosis of placental invasion anomalies

Aim: Complete blood count (CBC) parameters are used to assess subclinical inflammation in various malignancies and autoimmune diseases. The abnormal trophoblastic invasion in placenta previa, similar to uncontrolled tumor cell growth, occurs with acute and chronic inflammation. Accordingly, this study aimed to evaluate the clinical utility of CBC parameters for the antepartum diagnosis of placental invasion anomalies. Materials and Methods: The study was designed as a retrospective case-control study and carried out at our tertiary obstetric clinic between January 2016 and December 2019. A total of 181 participants were divided into three groups as follows: 77 patients who underwent a cesarean section with a diagnosis of Placenta previa (PP), 52 patients with a histopathologically confirmed diagnosis of Placenta Accreata Spectrum (PAS), and 52 control patients without PAS and without PP. Complete blood count (CBC) parameters were evaluated and compared. Results: White blood cell (p<0.001), neutrophil count (p=0.005) and neutrophil-to-lymphocyte ratio (p=0.002) were found to be significantly higher, mean platelet volume (p<0.001) and plateletcrit levels (p=0.050) were significantly lower in the Placenta Previa group compared to the control group. Also, neutrophilto-lymphocyte ratio (p<0.001) and platelet distribution width (p=0.027) were higher, and lymphocyte count (p=0.021), mean platelet volume (p<0.001) and plateletcrit (p<0.001) levels were lower in Placenta Accreta Spectrum group compared to the control group. In multivariate analyses, mean platelet volume (OR 4.01; 95% CI 2.4-6.6), red blood cell (OR 3.12; 95% CI 2.72-3.56) and platelet distribution width (OR 0.22; 95% CI 0.17-0.28.) were significantly associated with the placental invasion anomaly (p<0.001). Discussion: Antepartum use of CBC parameters for the detection of the peripheral blood cell changes of acute and chronic inflammation secondary to placental invasion can contribute to the prediction and radiological diagnosis of placental invasion anomalies.