The relationship between changes in ultrasound blood flow parameters combined with D-dimer,25-hydroxy vitamin D levels and fetal growth indicators and birth outcomes
Objective To explore the relationship between changes in ultrasound blood flow parameters combined with serum D-dimer and 25 hydroxyvitamin D[25-(OH)D]levels with fetal growth indicators and birth outcomes.Methods A total of 164 pregnant women who underwent regular prenatal examinations and gave birth at our hospital from November 2021 to February 2023 were selected as the study subjects.According to the fetal birth outcomes,pregnant women were divided into two groups:the good birth outcome group(n=110)and the poor birth outcome group(n=54).Fetal growth indicators during the second and third trimesters were collected,including biparietal diameter(BPD),head circumference(HC),abdominal circumference(AC),femoral length(FL),and umbilical artery blood flow parameters:pulsatility index(PI),resistance index(RI),and systolic/diastolic ratio(S/D).Serum D-dimer and 25-hydroxyvitamin D levels were measured using enzyme-linked immunosorbent assay(ELISA).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of blood flow parameters combined with serum D-dimer and 25-(OH)D levels for fetal birth outcomes.Results In the late pregnancy stage,the blood flow parameters PI,RI,S/D and serum 25-(OH)D levels were significantly lower than those in the mid pregnancy stage(t=5.883,9.723,6.506,and 5.631,respectively,all P＜0.001).Serum D-dimer level and fetal growth indicators such as BPD,HC,AC,FL were significantly higher in late pregnancy compared to mid-pregnancy(t=4.479,74.673,27.840,35.009,and 36.904,respectively,all P＜0.05).In the favorable outcome group,blood flow parameters PI,RI,S/D,and serum D-dimer levels were lower than those in the adverse outcome group in late pregnancy(t=4.305,6.575,4.833,and 5.133,respectively,all P＜0.001),while 25-(OH)D levels were higher than in the adverse outcome group(t=8.345,P＜0.001).The ROC curve results showed that the combined detection of blood flow parameters PI,RI,S/D,and serum D-dimer and 25-(OH)D in late pregnancy predicted fetal birth outcomes with a sensitivity of 90.7％,specificity of 84.3％,and an area under the curve(AUC)of 0.962(95％CI:0.934-0.991),which was higher than the individual detection of PI,RI,S/D,D-dimer,or 25-(OH)D(P＜0.05).Conclusion There are significant differences in blood flow parameters PI,RI,S/D,serum D-dimer,25-(OH)D and fetal growth indicators in different pregnancy stages.The combination of blood flow parameters PI,RI,S/D with serum D-dimer and 25-(OH)D has good predictive value for fetal birth outcomes.
万方数据
维普
