Clinical Role of Hematologic Inflammatory Markers in the Diagnosis of Missed Abortion

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Abstract
Objectives: To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester. Methods: This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed. Results: The platelet count was significantly lower in the missed abortion group than in the control group (p = 0.049). No significant differences were found in NLR, PLR, LMR, SII and CAR levels. Only the MLR value was close to the threshold of statistical significance (p = 0.054). Conclusion: In our study, most systemic inflammation markers showed limited diagnostic utility for diagnosing missed abortions. These findings suggest that inflammation in the pathophysiology of missed abortion may be localised or time-dependent rather than systemic. Further prospective studies with larger cohorts are required to confirm these findings.

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