{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:03:08Z","timestamp":1791198188558,"version":"4.1.0"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","issue":"9","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to investigate the clinical, imaging, and hematological parameters predicting the necessity of surgical intervention in pregnant women presenting with symptomatic gestational hydronephrosis.  METHODS: We retrospectively evaluated 192 pregnant women diagnosed with symptomatic hydronephrosis between January 2015 and September 2024. Patients were divided into Group 1 (conservative management, n=138) and Group 2 (surgical intervention via double-J stent or percutaneous nephrostomy, n=54). Demographic data, clinical findings, degree of hydronephrosis, urinalysis, and complete blood count parameters\u2014including C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index\u2014were compared. Logistic regression analysis was performed to identify predictors for surgery.  RESULTS: A history of urolithiasis, prolonged pain, fever, severe hydronephrosis, pyuria, and elevated creatinine were significantly higher in Group 2 (p&lt;0.05). White blood cell, neutrophil-to-lymphocyte ratio, and C-reactive protein levels did not differ significantly between the groups. However, platelet counts (p=0.020), platelet-to-lymphocyte ratio (p=0.038), and systemic immune-inflammation index (p=0.015) were significantly elevated in the surgical cohort. Univariate logistic regression analysis revealed that an elevated platelet count (p=0.039) and a higher systemic immune-inflammation index (p=0.004) were significant predictors. In the multivariate analysis, the systemic immune-inflammation index remained an independent predictor (p=0.009), whereas platelet count did not.  CONCLUSION: While clinical presentation and the severity of hydronephrosis primarily indicate the need for surgical intervention, the systemic immune-inflammation index serves as a valuable, cost-effective auxiliary predictor among the hematological parameters.<\/jats:p>","DOI":"10.1590\/1806-9282.20260594","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:40:34Z","timestamp":1791196834000},"source":"Crossref","is-referenced-by-count":0,"title":["The role of hematological parameters and systemic immune-inflammation index in the management of symptomatic gestational hydronephrosis"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8910-9859","authenticated-orcid":false,"given":"Ubeyd","family":"Sungur","sequence":"first","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8691-2710","authenticated-orcid":false,"given":"Ka\u011fan","family":"Toksal","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9099-6718","authenticated-orcid":false,"given":"G\u00fcl \u015e\u00fcheda","family":"Sungur","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2435-5482","authenticated-orcid":false,"given":"Deniz Noyan","family":"\u00d6zl\u00fc","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-3756","authenticated-orcid":false,"given":"Mithat","family":"Ek\u015fi","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-1986","authenticated-orcid":false,"given":"Ali Emre","family":"Fakir","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4724-3053","authenticated-orcid":false,"given":"Alper","family":"Bitkin","sequence":"additional","affiliation":[{"name":"University of Health Sciences","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/1753495X251332667","article-title":"Hydronephrosis in pregnancy: critical factors determining urinary catheter use","volume":"19","author":"Demiro\u011flu \u00c7","year":"2026","journal-title":"Obstet Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1089\/end.2021.0876","article-title":"Symptomatic hydronephrosis and ureteral calculi in pregnancy: a narrative review with a proposed management protocol","volume":"36","author":"Keenan RA","year":"2022","journal-title":"J Endourol"},{"key":"ref3","first-page":"e52146","article-title":"The management of symptomatic hydronephrosis in pregnancy","volume":"16","author":"Hosny M","year":"2024","journal-title":"Cureus"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1080\/00016340701416713","article-title":"Comparative study of conservative and surgical management for symptomatic moderate and severe hydronephrosis in pregnancy: a prospective randomized study","volume":"86","author":"Tsai YL","year":"2007","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1007\/s11255-017-1619-6","article-title":"Conservative\/surgical treatment predictors of maternal hydronephrosis: results of a single-center retrospective non-randomized non-controlled observational study","volume":"49","author":"Ercil H","year":"2017","journal-title":"Int Urol Nephrol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1177\/03915603221135319","article-title":"Value of neutrophil-to-lymphocyte ratio in predicting surgical intervention for hydronephrosis during pregnancy","volume":"90","author":"Bozkurt M","year":"2023","journal-title":"Urologia"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"151973","DOI":"10.1016\/j.semperi.2024.151973","article-title":"Physiologic changes of pregnancy and considerations for screening and diagnosis of sepsis","volume":"48","author":"Conwell J","year":"2024","journal-title":"Semin Perinatol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.cca.2021.02.015","article-title":"Pregnancy-specific reference intervals for C-reactive protein improve diagnostic accuracy for infection: a longitudinal study","volume":"517","author":"Dockree S","year":"2021","journal-title":"Clin Chim Acta"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/j.pbj.0000000000000254","article-title":"Diagnostic accuracy of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and neutrophil-lymphocyte-to-platelet ratio biomarkers in predicting bacteremia and sepsis in immunosuppressive patients with cancer: literature review","volume":"9","author":"Martinez JM","year":"2024","journal-title":"Porto Biomed J"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.15537\/smj.2024.45.11.20240760","article-title":"Systemic immune-inflammatory index and platelet-to-lymphocyte ratio in intrahepatic cholestasis of pregnancy","volume":"45","author":"\u00c7all\u0131o\u011flu N","year":"2024","journal-title":"Saudi Med J"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1046\/j.1471-0528.2002.01545.x","article-title":"The management of symptomatic hydronephrosis in pregnancy","volume":"109","author":"Fainaru O","year":"2002","journal-title":"BJOG"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12894-022-00985-x","article-title":"The identification of pregnant women with renal colic who may need surgical intervention","volume":"22","author":"He 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Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000902214&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:40:37Z","timestamp":1791196837000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000902214&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000902214"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20260594","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20260594"}}