妊娠第7周超声检查指标和血清孕酮水平对自发性流产的预测价值研究

发布时间：2018-03-16 04:20

本文选题：流产　切入点：自然　出处：《中国全科医学》2017年13期 　论文类型：期刊论文

【摘要】：目的探讨妊娠第7周超声检查指标和血清孕酮水平对自发性流产的预测价值。方法选取2013年1月—2015年12月在丽水市妇幼保健院建档的孕妇220例,胎龄均为7周。均行经阴道超声检查,以收集第7周的胎儿心率(FHR)、平均孕囊直径(MGSD)、顶臀长(CRL),并计算平均孕囊直径-顶臀长比值(MGSD/CRL);同时行血清孕酮水平检测。根据后期妊娠结局,将纳入孕妇分为自发性流产组(n=34)和非自发性流产组(n=186)。比较两组超声检查指标和血清孕酮水平,并分析其对自发性流产的预测价值。结果两组年龄、胎龄、CRL、血清孕酮水平比较,差异无统计学意义(P0.05);自发性流产组FHR、MGSD、MGSD/CRL低于非自发性流产组,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,FHR、MGSD、MGSD/CRL是孕妇发生自发性流产的影响因素(P0.05)。受试者工作特征(ROC)曲线结果显示,FHR、MGSD、MGSD/CRL预测自发性流产的临界值分别为111.15次/min、16.00 mm、11.27,灵敏度分别为98.4%、78.0%、93.0%,特异度分别为88.2%、100.0%、91.2%,ROC曲线下面积(AUC)分别为0.863、0.745、0.848;三者联合应用预测自发性流产的灵敏度为89.2%,特异度为91.2%,AUC为0.948。结论妊娠第7周FHR、MGSD、MGSD/CRL及三者联合应用对自发性流产均有较好的预测价值。
[Abstract]:Objective to study the predictive value of ultrasound examination and serum progesterone level in spontaneous abortion in the 7th week of pregnancy. Methods 220 pregnant women who were in the Lishui Maternal and Child Health Hospital from January 2013 to December 2015 were selected. The gestational age was 7 weeks. All fetuses were examined by transvaginal ultrasound to collect fetal heart rate and FHRs, mean gestational sac diameter (MGSD), parietal and gluteal length (CRL), and to calculate the mean gestational sac diameter-hip length ratio (MGSD-CRLL). Serum progesterone levels were also measured according to the outcome of late pregnancy. Pregnant women were divided into spontaneous abortion group and non-spontaneous abortion group. The ultrasonic examination index and serum progesterone level were compared between the two groups, and their predictive value for spontaneous abortion was analyzed. Results the age, gestational age and serum progesterone levels were compared between the two groups. There was no significant difference between the two groups (P 0.05), and the FHR-MGSD-MGSD-CRL in spontaneous abortion group was lower than that in non-spontaneous abortion group. The results of multivariate Logistic regression analysis showed that MGSD / CRL was the influential factor of spontaneous abortion in pregnant women (P 0.05). The result of ROC curve showed that the critical value of predicting spontaneous abortion was 111.15 times / min / L, respectively. The sensitivity was 98.4% and 78.0% and 93.0, respectively, and the specificity was 88.20.100.0and the area under the ROC curve was 0.8630.7450.848, respectively. The sensitivity and specificity of the combined application for predicting spontaneous abortion were 89.2and 91.2AUC were 0.948 respectively. Conclusion in the 7th week of gestation, FHRM MGSDMGSD-CRL and their combined application in spontaneous spontaneous abortion are effective in the diagnosis of spontaneous spontaneous abortion. [WT5HZ] [WT5 "BZ] [WT5" HZ] [WT5 "BZ] [WT5BZ] the sensitivity of the combined use of the three methods in predicting spontaneous abortion is 89.2 and the specificity is 0.948. Abortion has good predictive value.
【作者单位】：浙江省丽水市妇幼保健院超声科;浙江省丽水市妇幼保健院检验科;上海市第十人民医院超声科;
【基金】：上海市卫生局科研课题(20134023)
【分类号】：R445.1;R714.21

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