{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:14:07Z","timestamp":1792455247910,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Problem<\/jats:title><jats:p>Cesarean scar pregnancy (CSP) is characterized by a gestational sac fully or partially implanted in the scar from a previous cesarean section. Systemic immune\u2010inflammation indices (SIIs) have recently been discussed as additional diagnostic markers in placenta accreta and preeclampsia. CSP shares a similar pathogenesis with these diseases, suggesting that assessing the SIIs and neutrophil\u2010to\u2010lymphocyte ratio (NLR) could enhance additional predictability in diagnosing CSP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of Study<\/jats:title><jats:p>In this study, we analyzed the complete blood counts between 264 women who were confirmed with CSP by ultrasound and 295 women who underwent elective termination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean counts of total white cells and neutrophils were significantly higher, whereas the counts of monocytes, lymphocytes, and platelets were significantly lower in the CSP group compared to the control group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Additionally, the SII, systemic inflammation response index (SIRI), or NLR was significantly higher in the CSP group compared to the control group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). Given the limited effect of SII and SIRI on the increased risk of developing CSP, the optimal cut\u2010off value for NLR in predicting CSP was 2.87 (area under the curve [AUC] 0.656, 68% sensitivity). The optimal cut\u2010off value for NLR in predicting type 2 CSP was 2.91 (AUC 0.690, 71% sensitivity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although ultrasound or magnetic resonance imaging images are a gold standard for visualizing the gestational sac's location in the diagnosis of CSP, assessing peripheral blood tests is cost\u2010effective, and NLR may provide additional diagnosis value for CSP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13924","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T13:24:39Z","timestamp":1725283479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Systemic Immune\u2010Inflammation Indices Could Be Additional Predictive Markers for Cesarean Scar Pregnancy"],"prefix":"10.1111","volume":"92","author":[{"given":"Jing","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Obstetrics and Gynaecology Hospital of Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanyan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Obstetrics and Gynaecology Hospital of Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-6331","authenticated-orcid":false,"given":"Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Wuxi Maternity and Child Health Hospital, Jiangnan University Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhui","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Family Planning Obstetrics and Gynaecology Hospital of Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16951"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2017-0189"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoab019"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.03.007"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.12.130"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.06.024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.10.028"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.06.030"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2014.954101"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmb2.12532"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2010.05938.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1001785"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040967"},{"issue":"7","key":"e_1_2_10_15_1","first-page":"474","article-title":"Neutrophil\u2010to\u2010Lymphocyte Ratio, Past, Present and Future Perspectives","volume":"122","author":"Zahorec R.","year":"2021","journal-title":"Bratislavske Lekarske Listy"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1755-7682-5-2"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15254"},{"issue":"8","key":"e_1_2_10_18_1","article-title":"Is the First\u2010Trimester Systemic Immune\u2010Inflammation Index Associated With Preeclampsia?","volume":"15","author":"Cevher Akdulum M. 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