Diagnostic value of transvaginal color Doppler sonography combined with serum β-HCG and progesterone detection for intrauterine and extrauterine compound pregnancy after IVF-ET surgery
Objective To explore the diagnostic value of transvaginal color Doppler sonography(TVCDS)combined with serum β-human chorionic gonadotropin(β-HCG)and progesterone testing in the diagnosis of heterotopic pregnancy(HP)after in vitro fertilization and embryo transfer(IVF-ET).Methods A total of 94 pregnant women who experienced HP after IVF-ET in our hospital from January 2021 to June 2022 were selected as the study group.Additionally,80 patients with normal pregnancies following IVF-ET during the same period were selected as the control group.Receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic value of serum β-HCG and progesterone for postoperative HP after IVF-ET.The fourfold table method was applied to analyze the diagnostic value of TVCDS,as well as the combination of TVCDS with serum β-HCG and progesterone for HP after IVF-ET.Kappa test was performed to analyze the consistency of TVCDS and the combination of the three diagnostic methods with clinical diagnoses for HP after IVF-ET.Results TVCDS examination of patients with HP revealed an intrauterine gestational sac,while an ectopic gestational sac or mass was observed in the adnexal region,with 37 cases showing direct signs and 48 cases showing indirect signs.Serum levels of β-HCG and progesterone in the study group were significantly lower than those in the control group(t=14.881 and 14.705,respectively,P＜0.001).The area under the curve(AUC)for serumβ-HCG and progesterone in diagnosing HP following IVF-ET were 0.914(95％CI:0.862-0.951)and 0.929(95％CI:0.880-0.962),respectively,with sensitivities of 90.42％ and 91.48％,and specificities of 80.00％ and 82.50％.The sensitivity of TVCDS alone in diagnosing HP post-IVF-ET was 75.53％,specificity was 85.00％,and accuracy was 79.88％,demonstrating moderate consistency with clinical diagnosis(Kappa=0.599,P＜0.001).When combined with serum β-HCG and progesterone,the sensitivity for diagnosing HP after IVF-ET increased to 95.74％,with a specificity of 77.50％and an accuracy of 87.35％,indicating high consistency with clinical diagnosis(Kappa=0.742,P＜0.001).Conclusion TVCDS combined with serum β-HCG and progesterone has high diagnostic value for postoperative HP after IVF-ET.
transvaginal color Doppler sonographyβ-human chorionic gonadotropinprogesteronein vitro fertilization and embryo transferheterotopic pregnancy
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维普
