摘要
目的 探讨早孕期妊娠囊声像图特征与妊娠结局的相关性.方法 回顾性分析2019年9月至2022年9月于中国科学技术大学附属第一医院(安徽省立医院)南区就诊并在超声科行早孕超声检查的198例孕妇的临床资料,根据妊娠结局分为持续妊娠组(n=172)与妊娠失败组(n=26).比较两组孕妇的头臀长、胎心率、妊娠囊最大径、妊娠囊最小径、胚芽长、妊娠囊平均径与胚芽长差值.经二元Logistic回归分析影响妊娠结局的独立因素,受试者操作特征(ROC)曲线比较各项指标对早期妊娠结局的预测价值.结果 持续妊娠组与妊娠失败组的胚芽长、头臀长比较,差异均无统计学意义(P＞0.05);持续妊娠组的胎心率为(116.56±12.65)次/min,高于妊娠失败组[(91.46±13.97)次/min],妊娠囊最大径、最小径、妊娠囊平均径与胚芽长差值分别为(34.46±6.51)、(19.12±5.12)、(13.52±1.54)mm,均大于妊娠失败组[(22.12±6.01)、(15.71±4.11)、(9.65±1.86)mm],差异均有统计学意义(P＜0.05).经二元Logistic回归分析,妊娠囊最大径、妊娠囊最小径、妊娠囊平均径与胚芽长差值是孕早期孕妇妊娠结局的独立因素(P＜0.05).同时,经ROC曲线分析,胎心率、妊娠囊最大径、妊娠囊最小径、妊娠囊平均径与胚芽长差值预测孕早期孕妇妊娠结局的曲线下面积分别为0.914、0.922、0.718、0.942.结论 妊娠囊声像图特征对妊娠结局具有较好的预测价值,可作为早期妊娠妊娠结局的预测指标.当胎心率＜105.9次/min、妊娠囊最大径＜28.3 mm、妊娠囊最大径＜22.2 mm、妊娠囊平均径与胚芽长差值＜11.6 mm时,妊娠失败的概率均可增加,临床有必要进行更密切的随访.
Abstract
Objective To explore the correlation between the sonographic characteristics of gestational sac and pregnancy outcome in early pregnancy.Methods A retrospective analysis was performed on the ultrasonographic features of 198 pregnant women who visited the Southern District of the First Affiliated Hospital of the University of Science and Technology of China(Anhui Provincial Hospital)from September 2019 to September 2022 and underwent ultrasound examination of early pregnancy in the ultrasound department.According to the pregnancy outcome,they were divided into the continuous pregnancy group(n=172)and the pregnancy failure group(n=26).The head-buttock length,fetal heart rate,maximum diameter of gestational sac,minimum diameter of gestational sac,embryo length,average diameter of gestational sac and embryo length difference were compared between the two groups.The independent factors affecting pregnancy outcome were analyzed by binary Logistic re-gression,and the predictive value of each index for early pregnancy outcome was compared by receiver operating characteristic(ROC)curve.Re-sults There were no significant differences in the length of embryo and the length of head and buttocks between the continuous pregnancy group and the pregnancy failure group(P＞0.05).The fetal heart rate of the continuous pregnancy group was(116.56±12.65)times/min,which was higher than that of the pregnancy failure group[(91.46±13.97)times/min],the maximum diameter of the gestational sac,the minimum di-ameter,the difference between the average diameter of the gestational sac and the length of the embryo were(34.46±6.51),(19.12±5.12),(13.52±1.54)mm,respectively,which were all higher than those of the pregnancy failure group[(22.12±6.01),(15.71±4.11),(9.65±1.86)mm],and the differences were statistically significant(P＜0.05).Meanwhile,by ROC curve analysis,the area under the curve of fetal heart rate,maximum diameter,maximum diameter,and the difference of the outcome of early pregnancy were 0.914,0.922,0.718 and 0.942,re-spectively.Conclusion The features have good predictive value for pregnancy outcome and can be used as a predictive indicator of early pregnancy outcome.When the fetal heart rate is＜105.9 times/min,the maximum diameter of the pregnancy sac＜28.3 mm,the maximum diameter of the pregnancy sac＜22.2 mm.and the difference between the mean diameter of the pregnancy sac is＜11.6 mm.and closer follow-up is necessary.
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