The Predictive Value of TVCD Combined with Progesterone and HCG on Adverse Pregnancy Outcome
Objective To evaluate the predictive value of transvaginal color Doppler ultrasound combined with progesterone and human chorionic gonadotropin on adverse pregnancy outcomes.Methods The study subjects were 186 early pregnant women admitted to our hospital from December 2020 to December 2021 without clinical intervention.They were divided into control group(normal pregnancy,n=96)and observation group(adverse pregnancy,n=90)according to whether the pregnancy was normal;the patients in the control group were divided into C1 group(no threatened abortion,n=50)and C2 group(threatened abortion,n=46)according to whether there was threatened abortion;to analyze the predictive value of uterine blood flow parameters,HCG 48h growth rate and progesterone level on adverse pregnancy outcomes.Results There was no significant difference in PSV and Rl between the control group and the observation group(t=-0.766,0.307;P=0.445,0.760);the PI of the observation group was higher than that of the control group,and the difference was statistically significant(t=4.282;P＜O.001);the 48-hour increase of HCG and progesterone level in the observation group were lower than those in the control group,and the difference was statistically significant(t=-17.184,-14.888;both P＜O.001);there was no significant difference in PSV,PI and progesterone levels between C1 and C2 groups(t=-0.893,1.782,-1.414;P=0.374,0.078,0.161);the RI of group C2 was higher than that of group C1,and the difference was statistically significant(t=3.263;P=0.002);the 48-hour increase of HCG in group C2 was lower than that in group C1,and the difference was statistically significant(t=-3.273;P=0.002);logistic multivariate regression analysis showed that the 48-hour increase of HCG(OR:0.853;95％CI:0.732～1.096),progesterone level(OR:0.797;95％CI:0.625～1.013)and PI(OR:2.827;95％CI:1.001～7.876)were independent predictors of pregnancy outcome;the ROC curve analysis showed that the 48-hour growth rate of HCG,the AUC value of progesterone and PI were 0.855,0.845 and 0.659 respectively,and the AUC value of the combination of the three indicators was 0.915;the 48-hour growth rate of HCG,the sensitivity of progesterone,PI and the combination of three indicators were 84.37％,80.21％,73.96％and 88.54％respectively;the 48-hour increase of HCG,the specificity of progesterone,PI and the combination of three indicators were 86.67％,88.89％,57.78％and 94.44％respectively.Conclusion In the early stage of pregnancy,adverse pregnancy can be predicted by observing the PI value of uterine artery,HCG 48h growth amplitude and progesterone level.Compared with PI value,HCG 48h growth amplitude and progesterone level have higher predictive value,and the combination of three indicators has higher sensitivity and specificity in the diagnosis of adverse pregnancy.
万方数据
维普
