Predictive value of hemodynamic parameters and serum vitamin D and HCY in re-pregnancy miscarriage in RSA patients
Objective To analyze the uterine artery hemodynamic parameters,serum vitamin D and homocysteine expression levels in patients with recurrent spontaneous miscarriage(RSA)and their predictive value for recurrent miscarriage in RSA patients.Methods 82 RSA patients from Mianyang Central Hospital from September 2020 to September 2022 were selected as the research subjects.According to whether the outcome of the re-pregnancy was normal,they were divided into the re-normal group(33 cases)and the re-abortion group(49 cases),and 50 pregnant women with normal prenatal examination results in the same period were selected as the control group.Three groups underwent color Doppler ultrasound examination and serum testing,and the pulsatile index(PI),peak systolic/diastolic flow velocity(S/D),resistance index(RI),and serum 25(OH)D and HCY levels were compared among the three groups.The Logistic regression model was used to analyze the influencing factors of RS A occurrence.The correlation between various indicators and RS A was analyzed using Pearson correlation method.The diagnostic value of each indicator for RS A was analyzed using receiver operating characteristic(ROC)curve analysis.The chorionic tissue chromosomes of the aborted fetus in the re-abortion group were analyzed,and the uterine artery hemodynamic parameters and serum 25(OH)D and HCY levels were compared between the normal villus chromosome group and the abnormal group.Results The levels of PI,S/D,RI and HCY in the re-abortion group were higher than those in the control group and the re-normal group,and the serum 25(OH)D level was lower than that in the control group and the re-normal group,and the difference was statistically significant(P＜0.05).The increase in PI,S/D,RI values and HCY levels,as well as the decrease in 25(OH)D levels,were risk factors for recurrent miscarriage in patients with a history of RSA(P＜0.05).Pearson correlation analysis showed that re-miscarriage in patients with RSA history were positively correlated with PI,S/D,RI and HCY levels,and was negatively correlated with 25(OH)D level(P＜0.05).The ROC curve showed that the AUC of PI,S/D,RI,and serum 25(OH)D,HCY detected separately were 0.827,0.849,0.804,0.834,and 0.813,respectively.The AUC of the combined detection was 0.984,with a sensitivity of 92.7％and a specificity of 96.0％,the diagnostic value was higher than that of detection alone.In the re-abortion group,there were 29 cases of abnormal fetal villus chromosomes,and 20 cases were normal.There was no significant difference in uterine artery hemodynamic parameters,serum 25(OH)D and HCY levels between the normal villus chromosome group and the abnormal group(P＞0.05).Conclusion The increase of uterine artery hemodynamic parameters PI,S/D,RI and HCY levels in RSA patients,and the decrease in serum vitamin D level are risk factors for re-abortion in patients with a history of RSA.The combined detection of various indicators has certain predictive value for re-miscarriage in patients with a history of RSA.
recurrent spontaneous abortionuterine artery hemodynamic parametersvitamin Dhomocysteinepredictive value
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