Study of ultrasound measured relative size of gestational sac and serum progesterone levels in predicting first trimester pregnancy outcomes
Objective To explore the clinical value of the relative size of gestational sac and serum progesterone levels in predicting early pregnancy outcomes.Methods Retrospective cohort study selected patients who underwent early pregnancy ultrasound examination at the Ultrasound Medicine Department of Shanghai Changning Maternity and Infant Health Hospital from April 2020 to June 2023.Transvaginal two-dimensional ultrasound was used to measure the three diameters of the gestational sac(longitudinal diameter,transverse diameter,anterior-posterior diameter)and fetal pole length.Serum progesterone levels were tested in 3 d.All patients were followed up until 12 weeks of gestation to estimate the early pregnancy outcomes.Gestational age was calculated based on the gestational sac diameter line(Hellman's formula)and embryo length(Hadlock's formula),and the patients were divided into the gestational sac deviation group(deviation group,n=100)and the gestational sac normal group(normal group,n=500)based on the relative size of gestational age.The relative size of the gestational sac and progesterone level were compared between the two groups,and the effectiveness of predicting early pregnancy outcomes for statistically significant indicators was calculated with receiver operating characteristic curve.Results 1)The relative size of gestational sac in the normal group and the deviation group were 3.24±1.06 and 1.65±0.56,respectively,and the difference between the two groups was statistically significant(P=0.004).The positive predictive value of ultrasound gestational sac size for predicting adverse pregnancy outcome in the first trimester was 97.00%(97/100)and the negative predictive value was 94.2%(471/500).2)The levels of progesterone in the normal group and the deviation group were(68.4±37.2)nmol/L and(29.6±11.8)nmol/L,respectively,with a statistically significant difference(P<0.001).3)The areas under receiver operating characteristic curves of the relative size of gestational sac,progesterone levels and the both combined in predicting early pregnancy outcomes were 0.804,0.818 and 0.847,respectively,and the cut-off values of the relative size of pregnancy sac and progesterone was 2.40 and 37.6 nmol/L,respectively.4)The accuracy of the relative size of gestational sac in predicting adverse outcomes in early pregnancies was 76.98%(97/126).The accuracy of progesterone in predicting adverse outcomes in early pregnancy was 78.57%(99/126).When the both combined,the predicting accuracy was increased to 84.92%(107/126).Conclusion It is easy to measure and calculate the relative size of pregnancy sac by ultrasound,which provided a good predictive value for the outcomes of early pregnancies.The relative size of pregnancy sac combined with progesterone levels showed better predictive efficacy.
Early pregnancyRelative size of pregnancy sacProgesteronePregnancy outcomesPredicting value
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